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Certified Risk Adjustment Coder Jobs in West Virginia

WVU Medicine

Peds CRNA

Morgantown, WV · On-site

... adjustments. Provides timely notification to attending anesthesiologist regarding any and all ... risk of infection to patients, families, and coworkers. 3. Participates in the pre-anesthetic ...

West Virginia University Health System

... adjustments. Provides timely notification to attending anesthesiologist regarding any and all ... risk of infection to patients, families, and coworkers. 3. Participates in the pre-anesthetic ...

WVU Medicine

Peds CRNA

Morgantown, WV · On-site

... adjustments. Provides timely notification to attending anesthesiologist regarding any and all ... risk of infection to patients, families, and coworkers. 3. Participates in the pre-anesthetic ...

WVU Medicine

... adjustments. Provides timely notification to attending anesthesiologist regarding any and all ... risk of infection to patients, families, and coworkers. 3. Participates in the pre-anesthetic ...

Liquid Personnel

MASH Team Manager

Sutton, WV · Hybrid

Manage complex safeguarding decisions and provide expert consultation on high-risk cases ... Reasonable Adjustments: If you consider yourself to have a disability or require any reasonable ...

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Certified Risk Adjustment Coder information

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$54

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

As of Aug 2, 2026, the average hourly pay for certified risk adjustment coder in West Virginia is $22.67, according to ZipRecruiter salary data. Most workers in this role earn between $16.92 and $22.50 per hour, depending on experience, location, and employer.

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 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 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.

What are popular job titles related to Certified Risk Adjustment Coder jobs in West Virginia? For Certified Risk Adjustment Coder jobs in West Virginia, the most frequently searched job titles are:
What job categories do people searching Certified Risk Adjustment Coder jobs in West Virginia look for? The top searched job categories for Certified Risk Adjustment Coder jobs in West Virginia are:
Certified Risk Adjustment Coder jobs near you
Infographic showing various Certified Risk Adjustment Coder job openings in West Virginia as of July 2026, with employment types broken down into 1% As Needed, 75% Full Time, 16% Part Time, and 8% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $47,162 per year, or $22.7 per hour.

Risk Adjustment Coding Accuracy Specialist

Lumeris

Charleston, WV • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago

Job description

Your Future is our Future


At Lumeris,we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact.


We're excited to consider every qualified candidate authorized to work in the United States, although we are unable to sponsor visas for this role at this time.

Position:Risk Adjustment Coding Accuracy SpecialistPosition Summary:Responsible for implementation of initiatives to improve documentation and coding accuracy for Lumeris clients. Regularly reviews provider medical records for accurate and complete documentation and coding. Supports retrospective chart reviews as well as pre-visit planning and post visit coding.Job Description:

Primary Responsibilities:

  • Reviews medical records in support or pre-visit planning and post-visit program for opportunities with complete and accurate documentation and coding
  • Identifies chronic conditions for providers to review during patient visits
  • Queries providers to ensure complete and accurate documentation and coding after patient visits
  • Partners with providers and clinical/administrative staff to enhance understanding of Clinical Documentation Improvement program goals in order to achieve Risk Adjustment strategic goals and initiatives.
  • Maintains current subject matter expertise by attending professional meetings, seminars, and related continuing education events.
  • Collaborates with internal teams to assure client / project-specific goals are met.
  • Reviews project specific documentation and code specificity for validation.
  • Supports in oversight (overreads) of coding vendor.
  • Responsible for communication, input and findings to support Senior Auditors.

Qualifications:

  • Bachelor's degree or equivalent
  • 3+ years of ICD-10 outpatient coding and provider query experience or the knowledge, skills, and abilities to succeed in the role
  • Strong knowledge of ICD-10-CM Coding Guidelines, E/M, CPT/HCPCS, CMS-HCC risk adjustment model, medical record review project management, encounter data management, and IPM/RADV Medical Record Reviewer Guidance
  • Coding certification as CPC
  • Demonstrated ability to work cross-functionally within corporate matrix environments
  • Effective ability to collaborate and partner on complicated initiatives
  • Firm verbal and written communication skills
  • Favorable computer skills (i.e. Microsoft Office)
Preferred:
  • Associate degree or technical school
  • CPC-I or CRC Certifications

Working Conditions

  • While performing the duties of this job, the employee works in normal office working conditions
#LI-RemotePay Transparency:

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements.

The hiring range for this position is:

$54,800.00-$73,250.00

Benefits of working at Lumeris

  • Medical, Vision and Dental Plans

  • Tax-Advantage Savings Accounts (FSA & HSA)

  • Life Insurance and Disability Insurance

  • Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)

  • Employee Assistance Program

  • 401k with company match

  • Employee Resource Groups

  • Employee Discount Program

  • Learning and Development Opportunities

  • And much more...

Be part of a team that is changing healthcare!


Member Facing Position: No- Not Member or Patient Facing Position
Drug Screen Requirement: Location:United StatesTime Type:Full timeLumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.Disclaimer:
  • The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential job duties and responsibilities.
Lumeris is an EEO/AA employer M/F/V/D.

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