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Certified Risk Adjustment Coder Jobs in Chicago, IL

Deloitte

Health Actuary Consulting Manager

Chicago, IL · On-site

... risk adjustment mechanisms, group insurance products, mergers and acquisitions, or health care ... certifications; and other business and organizational needs. The disclosed range estimate has not ...

CNA

Principal AI Engineer

Chicago, IL · On-site

... CNA's AI-native engineering platform, designing the end-to-end system spanning agentic coding ... for different risk profiles (e.g., Sox-classified systems vs. rapid prototyping). * Leads the ...

Cna

Principal AI Engineer

Chicago, IL

... CNA's AI-native engineering platform, designing the end-to-end system spanning agentic coding ... for different risk profiles (e.g., Sox-classified systems vs. rapid prototyping). * Leads the ...

Cna

Principal AI Engineer

Chicago, IL

... CNA's AI-native engineering platform, designing the end-to-end system spanning agentic coding ... for different risk profiles (e.g., Sox-classified systems vs. rapid prototyping). * Leads the ...

CNA

Principal AI Engineer

Chicago, IL · On-site

... CNA's AI-native engineering platform, designing the end-to-end system spanning agentic coding ... for different risk profiles (e.g., Sox-classified systems vs. rapid prototyping). * Leads the ...

CNA

System Architect Director - AI Innovation

Chicago, IL · On-site

$250K/yr

At CNA, we strive to create a culture in which people know they matter and are part of something ... Enables Claude Code safely in enterprise environments, defining usage guardrails for file edits ...

Cna

System Architect Director - AI Innovation

Chicago, IL · On-site

$250K/yr

At CNA, we strive to create a culture in which people know they matter and are part of something ... Enables Claude Code safely in enterprise environments, defining usage guardrails for file edits ...

Origami Risk LLC

Site Reliability Engineer

Chicago, IL · On-site +1

$100K - $120K/yr

Education Assistance Program - to help colleagues pursue industry/role-specific certifications ... Dais Technology, a subsidiary of Origami Risk, provides a no-code platform that revolutionizes ...

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All JobsCertified Risk Adjustment Coder JobsCertified Risk Adjustment Coder Jobs in Chicago, IL

Certified Risk Adjustment Coder information

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

As of Sep 4, 2026, the average hourly pay for certified risk adjustment coder in Chicago, IL is $30.17, according to ZipRecruiter salary data. Most workers in this role earn between $22.55 and $29.95 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 Chicago, IL?

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

What job categories do people searching Certified Risk Adjustment Coder jobs in Chicago, IL look for?

The top searched job categories for Certified Risk Adjustment Coder jobs in Chicago, IL are:

Certified Risk Adjustment Coder jobs near you
Infographic showing various Certified Risk Adjustment Coder job openings in Chicago, IL as of August 2026, with employment types broken down into 2% As Needed, 72% Full Time, 19% Part Time, 6% Contract, and 1% Nights. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $62,805 per year, or $30.2 per hour.

Director of Risk Management and Compliance

Christian Community Health Center

Chicago, IL • On-site

$80K - $85K/yr

Full-time

Medical, Dental, Vision, Life

Re-posted 8 days ago

Job description

Job Title
Director of Risk Management and Compliance
Reports To:
Chief Operations Officer
FLSA Status:
Exempt
POSITION SUMMARY
The Compliance & Risk Manager is responsible for supporting the development, implementation, and ongoing oversight of the CCHC's Compliance Program and Enterprise Risk Management (ERM) framework. This position ensures adherence to federal and state regulations-including HRSA, CMS, FTCA, HIPAA, OSHA, 340B, Medicaid/Medicare billing requirements-and proactively identifies and mitigates organizational risks.
The Compliance & Risk Manager partners closely with clinical, operational, finance, pharmacy, and administrative departments to ensure policies, procedures, performance improvement, and quality initiatives are aligned with HRSA compliance, industry best practices, and organizational goals.
KEY RESPONSIBILITIES
1. Compliance Program Oversight
  • Support administration of the organization's Corporate Compliance Program in accordance with HRSA's requirements, Federal Sentencing Guidelines, and OIG Compliance Program Guidance.
  • Conduct routine audits and compliance reviews of operational, clinical, financial, and billing functions.
  • Help develop and maintain policies and procedures addressing compliance, regulatory, privacy, and risk matters.
  • Coordinate the annual HRSA Operational Site Visit (OSV) preparation, monitoring, and corrective action plans.
  • Monitor regulatory updates and communicate changes to leadership and staff.

2. Risk Management & Regulatory Readiness
  • Support the organization's Enterprise Risk Management (ERM) process, including risk identification, risk scoring, mitigation planning, and tracking.
  • Conduct Root Cause Analyses (RCA) and implement corrective actions for adverse events, near misses, or compliance concerns.
  • Maintain incident reporting processes and track trends.
  • Serve as liaison for insurance carriers, including liability, property, workers' compensation, and FTCA requirements.
  • Assist with emergency preparedness compliance, OSHA oversight, and Environment of Care coordination.

3. HIPAA Privacy & Security Compliance
  • Participate in monitoring compliance with HIPAA Privacy, Security, and Breach Notification Rules.
  • Investigate privacy incidents and potential breaches; develop corrective action plans.
  • Conduct annual HIPAA training and workforce education.
  • Collaborate with IT to ensure alignment with information security policies and safeguards.

4. 340B Program Oversight (as applicable)
  • Assist with compliance monitoring of the 340B Drug Pricing Program in collaboration with pharmacy leadership.
  • Support internal audits for 340B eligible encounters, prescription validation, contract pharmacy oversight, diversion, and duplicate discount prevention.
  • Maintain documentation required for HRSA 340B audits and program integrity monitoring.

5. Internal Audits & Monitoring
  • Develop, schedule, and perform compliance and risk audits, including:
  • Billing and coding
  • Eligibility and sliding fee scale
  • Documentation standards
  • Credentialing compliance
  • Referral and care coordination documentation
  • Quality improvement program alignment
  • Prepare audit reports and present findings to leadership.

6. Training, Education & Communication
  • Conduct compliance, HIPAA, regulatory, and risk management training for new hires and current staff.
  • Provide coaching and support to leaders on compliance-related questions.
  • Maintain communication tools such as newsletters, alerts, intranet posts, and compliance dashboards.

7. Investigations
  • Conduct internal compliance investigations, including interviewing staff, reviewing documentation, and analyzing findings.
  • Document outcomes and ensure appropriate corrective or disciplinary actions are implemented.

8. Corporate Governance Support
  • Support the compliance committee and quality/risk committees.
  • Assist with board reporting, annual risk assessments, and organizational compliance metrics.

Maintain documentation necessary for HRSA Section 330-related compliance elements.
QUALIFICATIONS
  • Masters degree in Health Administration, Public Health, Nursing, Business, or related field required,
  • Minimum 3-5 years of experience in healthcare compliance, risk management, quality improvement, or regulatory operations (FQHC preferred).
  • Knowledge of HRSA, FTCA, CMS, Medicaid/Medicare, HIPAA, OSHA, and 340B program requirements.
  • Certification preferred (one or more):
  • CHC (Certified in Healthcare Compliance)
  • CCEP (Certified Compliance and Ethics Professional)
  • CPHRM (Certified Professional in Healthcare Risk Management)
  • CPPS (Patient Safety)
  • CHPC (HIPAA Privacy Certified)

KEY COMPETENCIES
  • Strong understanding of FQHC regulatory and compliance frameworks
  • Ability to conduct audits, analyze findings, and drive corrective action
  • Knowledge of healthcare billing, coding, eligibility, and reimbursement processes
  • Excellent communication, training, and investigation skills
  • Strong analytical, organizational, and project management abilities
  • Ability to collaborate effectively with clinical and administrative leaders
  • High integrity, discretion, and sound judgment

Employee Benefits offered to Fulltime Staff
  • Blue Cross Blue Shield Medical Insurance
  • Blue Cross Blue Shield Dental and Vision Insurance
  • Supplemental Benefits
  • Life Insurance (Provided by the company)

Pay Range: $80,000 - $85,000 per year

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