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Certified Risk Adjustment Coder Jobs in Rhode Island

... or procedural adjustments to mitigate the same while supporting strategic aims. * Process ... Professional certifications (e.g., CRMA, FRM) preferred. * Minimum 5 years of experience in ...

... or procedural adjustments to mitigate the same while supporting strategic aims. * Process ... Professional certifications (e.g., CRMA, FRM) preferred. * Minimum 5 years of experience in ...

... or procedural adjustments to mitigate the same while supporting strategic aims. * Process ... Professional certifications (e.g., CRMA, FRM) preferred. * Minimum 5 years of experience in ...

Enterprise Risk Manager

Middletown, RI · On-site

$100 - $125/hr

... or procedural adjustments to mitigate the same while supporting strategic aims. * Process ... Professional certifications (e.g., CRMA, FRM) preferred. * Minimum 5 years of experience in ...

Finance Tutor

Providence, RI · Remote

$18 - $40/hr

... certification examinations. * Conceptual Teaching & Problem-Solving: Skilled at breaking down ... risk adjustment in valuation, and interpreting financial ratios. Adapts instruction using financial ...

Principal Software Engineer

North Kingstown, RI · On-site

$130K - $175K/yr

Advise engineering leadership on software architecture, certification risk, and build-vs-buy. What ... MATLAB/Simulink/Embedded Coder; multi-program technical direction; chief-engineer or deputy-CE ...

Advise engineering leadership on software architecture, certification risk, and build‑vs‑buy ... MATLAB/Simulink/Embedded Coder; multi‑program technical direction; chief‑engineer or ...

Develop and maintain project risk assessments, qualitative and quantitative. * Develop and maintain ... Experience with estimate validation and adjustments and comparative cost analyses. * Knowledge of ...

Develop and maintain project risk assessments, qualitative and quantitative. * Develop and maintain ... Experience with estimate validation and adjustments and comparative cost analyses. * Knowledge of ...

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Certified Risk Adjustment Coder information

See Rhode Island salary details

$16

$28

$69

How much do certified risk adjustment coder jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for certified risk adjustment coder in Rhode Island is $28.68, according to ZipRecruiter salary data. Most workers in this role earn between $21.44 and $28.46 per hour, depending on experience, location, and employer.

What is a Certified Risk Adjustment Coder?

A Certified Risk Adjustment Coder is a professional who specializes in reviewing and coding medical records to ensure accurate documentation of diagnoses for risk adjustment purposes. These coders play a crucial role in healthcare reimbursement, especially for Medicare Advantage and other risk-adjusted health plans. They analyze patient records using ICD-10-CM codes to help healthcare organizations receive appropriate compensation based on the severity of patient conditions. Certified Risk Adjustment Coders typically hold certifications such as the CRC from the AAPC, demonstrating their expertise in this specialized field.

What are the key skills and qualifications needed to thrive as a Certified Risk Adjustment Coder, and why are they important?

To thrive as a Certified Risk Adjustment Coder, you need expertise in medical coding, a thorough understanding of ICD-10-CM guidelines, and certification such as CRC (Certified Risk Adjustment Coder). Familiarity with coding software, electronic health records (EHRs), and risk adjustment models like HCC is typically required. Attention to detail, analytical thinking, and strong communication skills help ensure accurate code assignment and effective collaboration with healthcare providers. These skills and qualifications are crucial for capturing precise patient data, which directly impacts healthcare reimbursement and compliance.

What are some common challenges Certified Risk Adjustment Coders face, and how can they overcome them?

Certified Risk Adjustment Coders often encounter challenges such as staying current with evolving coding guidelines and accurately interpreting complex medical records. To overcome these difficulties, coders should regularly participate in ongoing education, leverage resources from professional organizations, and collaborate closely with providers to clarify documentation. Maintaining a strong attention to detail and utilizing coding software tools can also help minimize errors and improve coding accuracy. Engaging in peer reviews within the team can further enhance consistency and knowledge sharing.

What is the difference between Certified Risk Adjustment Coder vs Certified Medical Coder?

AspectCertified Risk Adjustment CoderCertified Medical Coder
CertificationsRequires risk adjustment-specific credentials like RAC, CRC, or CPC-RRequires CPC or CCS certifications
Work EnvironmentPrimarily in health insurance, risk adjustment, and payer settingsHospitals, clinics, physician offices, and outpatient facilities
Industry UsageUsed mainly in health insurance and risk adjustment programsUsed across healthcare providers for medical coding and billing

The Certified Risk Adjustment Coder specializes in coding for risk adjustment programs within health insurance, focusing on accurate documentation for reimbursement. In contrast, the Certified Medical Coder works across various healthcare settings, primarily coding diagnoses and procedures for billing. While both roles require coding certifications, their focus areas and work environments differ significantly.

How do you become a certified risk adjustment coder?

To become a certified risk adjustment coder, you typically need to complete relevant training or coursework in medical coding and risk adjustment, gain experience in medical billing or coding, and pass a certification exam such as the Certified Risk Adjustment Coder (CRC) offered by the American Academy of Professional Coders (AAPC). Continuing education is often required to maintain certification and stay current with industry updates.

Is certified risk adjustment coding a good career?

Certified risk adjustment coding is a growing field within healthcare, focusing on accurately coding patient diagnoses for insurance reimbursement and risk assessment. It requires knowledge of medical terminology, coding systems like ICD-10, and often involves certification such as the RAC or CRC. The role offers stable employment opportunities, competitive salaries, and the potential for remote work, making it a viable career choice for those interested in healthcare administration and coding.

What are popular job titles related to Certified Risk Adjustment Coder jobs in Rhode Island?

For Certified Risk Adjustment Coder jobs in Rhode Island, the most frequently searched job titles are:

What job categories do people searching Certified Risk Adjustment Coder jobs in Rhode Island look for?

The top searched job categories for Certified Risk Adjustment Coder jobs in Rhode Island are:

Infographic showing various Certified Risk Adjustment Coder job openings in Rhode Island as of August 2026, with employment types broken down into 2% As Needed, 80% Full Time, 12% Part Time, and 6% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $59,659 per year, or $28.7 per hour.

Risk Adjustment Coding Analyst

Providence, RI • On-site

CenterWell
Health Care and Social Assistance

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago


CenterWell rating

9.0

Company rating: 9.0 out of 10

Based on 10 frontline employees who took The Breakroom Quiz


Job description

Become a part of our caring community

The Risk Adjustment Coding Analyst provides operational, analytical, and administrative support to business leaders and teams. You will analyze data to support decision-making, performance monitoring, project tracking, and partner communication.

  • You will develop recurring dashboards and reports that support operational oversight, analytics, compliance monitoring, and leadership decision-making.

  • You will analyze operational trends, variances, aging, volumes, activity breakdowns, and performance changes; summarize findings in a clear business narrative with important takeaways and recommended next steps.

  • Prepare executive-ready summaries, presentations, and written analyses that explain the "story behind the data" rather than relying solely on raw reports or pivot tables.

  • Support recurring and ad hoc reporting needs, including dashboard maintenance, pending work analyses, activity tracking, audit reporting, GenAI-related reporting, CDI tracking, query tracking, and other priorities.

  • Partner with leaders and teams to define reporting needs, resolve data issues, and support interpretation of results.

  • Document active deliverables, reporting schedule, data sources, process notes, dependencies, risks, and transition plans to ensure business continuity knowledge transfer.

  • You will manage priorities, meet deadlines, escalate barriers, and make independent decisions regarding work methods within established guidelines.

  • Maintain confidentiality and handle sensitive business, operational, and healthcare-related information observing organizational policies and compliance expectations.

  • Improve reporting processes by identifying opportunities to improve manual work, strengthen data quality, enhance partner usability, and improve the clarity of deliverables.

Use your skills to make an impact

Required Qualifications:

  • Bachelor's degree or equivalent experience in business, analytics, healthcare administration, operations, information management, or a related field.

  • Experience supporting operations, analytics, project coordination, or administrative responsibilities.

  • Proficiency with Microsoft Office Suite with the ability to organize data, create summaries, and support presentation-ready deliverables.

  • Validate data, identify trends, compare time periods, calculate changes, and explain findings in concise language.

  • Produce written summaries including main insights, and recommend next steps for leadership review.

  • Validate calculations, removing duplicates, and confirming assumptions before sharing deliverables.

  • Partner across teams and translate partner requests into applicable reporting or documentation.

  • Maintain confidentiality and handle sensitive operational, employee, provider, member, and business information.

  • Experience improving business processes, partner experience, and operational outcomes through accurate reporting and applicable insights.

Preferred Qualifications:

  • Experience managing dashboards, trackers, scorecards, or recurring performance reports.

  • Experience with Excel-based analysis, Power BI, SharePoint, OneDrive, Teams, or other collaboration and reporting platforms.

  • Experience supporting healthcare operations, risk adjustment, coding operations, audit reporting, CDI tracking, provider education reporting, or similar regulated activities.

  • Convert complex data into executive-ready summaries, visual tables, trend narratives, and partner-facing updates.

  • Experience documenting processes, creating transition plans, maintaining report inventories, and supporting knowledge transfer.

  • Comfort working with latest tools, including AI-assisted summaries or analytics, while validating outputs for accuracy before use.

  • Identify data discrepancies, clarify definitions, align reporting logic, and support interpretation across partners.

#LI-CM1

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$58,700 - $70,400 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 09-18-2026

About us

About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.

About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at?CenterWell.com.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options https://www.partnersinprimarycare.com/accessibility-resources


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