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Certified Risk Adjustment Coder Jobs in Phoenix, AZ

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

Certified professional coder (CPC) * 3+ year(s) retrospective risk adjustment coding experience. * 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV ...

TEKsystems

Risk Adjustment Coding Auditor

Phoenix, AZ · Remote

$32 - $37/hr

CRC (Certified Risk Coder) certification in good standing. * Knowledge of Medicare, Medicaid, and ACA Commercial risk adjustment models. * Ability to interpret and apply coding policies, regulations ...

Cliff Services Inc

Data Risk Analyst

Phoenix, AZ · On-site

Phoenix , AZ Please find the JD Below The Risk Adjustment Analyst serves as a data and strategic specialist who tracks health plan performance and financial risk By using advanced coding ...

American Vision Partners

Certified Coder

Phoenix, AZ

$20.75 - $27.50/hr

Posts any related payments and/or adjustments for surgery charges posted * Makes changes to ... Certified Processional Coder (CPC) or Certified Coding Specialist (CCS) required * 5+ years medical ...

American Vision Partners

Certified Coder

Phoenix, AZ

$20.75 - $27.50/hr

Posts any related payments and/or adjustments for surgery charges posted * Makes changes to ... Certified Processional Coder (CPC) or Certified Coding Specialist (CCS) required * 5+ years medical ...

American Vision Partners

Certified Coder

Phoenix, AZ · On-site

$20.75 - $27.50/hr

Posts any related payments and/or adjustments for surgery charges posted * Makes changes to ... Certified Processional Coder (CPC) or Certified Coding Specialist (CCS) required * 5+ years medical ...

American Vision Partners

Certified Coder

Phoenix, AZ

$20.75 - $27.50/hr

As a Certified Coder, you'llberesponsible for the assignment of ICD-10 diagnoses and CPT procedure ... Posts any related payments and/or adjustments for surgery charges posted * Makes changes to ...

Valleywise Health System

CDI Specialist RN Ld

Phoenix, AZ · On-site

$39.96 - $58.94/hr

Certification/Licensure: * Requires a current, valid AZ RN license, or valid compact RN licensure ... Advanced knowledge of ICD-10-CM/PCS, MS-DRG/APR-DRG methodologies, risk adjustment, and coding ...

Deloitte

Medicaid Actuarial Senior Manager

Tempe, AZ · On-site

Experience with risk adjustment mechanisms * Experience with Provider reimbursement streams (i.e ... certifications; and other business and organizational needs. The disclosed range estimate has not ...

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Certified Risk Adjustment Coder information

See Phoenix, AZ salary details

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$27

$67

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

As of Aug 3, 2026, the average hourly pay for certified risk adjustment coder in Phoenix, AZ is $27.77, according to ZipRecruiter salary data. Most workers in this role earn between $20.72 and $27.60 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 Phoenix, AZ? For Certified Risk Adjustment Coder jobs in Phoenix, AZ, the most frequently searched job titles are:
What job categories do people searching Certified Risk Adjustment Coder jobs in Phoenix, AZ look for? The top searched job categories for Certified Risk Adjustment Coder jobs in Phoenix, AZ are:
Certified Risk Adjustment Coder jobs near you
Infographic showing various Certified Risk Adjustment Coder job openings in Phoenix, AZ as of July 2026, with employment types broken down into 67% Full Time, 22% Part Time, and 11% Contract. Highlights an 67% In-person, 22% Hybrid, and 11% Remote job distribution, with an average salary of $57,769 per year, or $27.8 per hour.

Senior Manager, Corporate Compliance - Risk Adjustment

CVS Health

Scottsdale, AZ

$75K - $165K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 11 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,326 frontline employees who took The Breakroom Quiz

88th of 110 rated pharmacies

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.

The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.

Key Responsibilities

  • Lead the Medicare Advantage Risk Adjustment compliance program.

  • Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.

  • Assess operational processes for compliance risks related to risk adjustment activities.

  • Develop and implement corrective action plans for identified compliance issues.

  • Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.


Required Qualifications

  • Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance

  • Minimum 5 years in a leadership role

  • One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)

  • Willingness to travel up to 10% (including by plane)


Preferred Qualifications

  • Health Information Management (RHIA/RHIT)

  • Nursing - Strong understanding of clinical documentation and medical record review

  • Certified Risk Adjustment Coder (CRC) with compliance experience

  • Provider coding audit/compliance leadership experience

  • Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits


Education

Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.

Pay Range

The typical pay range for this role is:

$75,400.00 - $165,954.00


This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/12/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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