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Certified Risk Adjustment Coder Jobs (NOW HIRING)

Cano Health

Risk Adjustment Coder

Jupiter, FL · On-site

The Risk Adjustment Coder is required to follow procedures and documentation policies regarding ... CPC or CRC Coding Certification Knowledge, Skills & Proficiencies * Builds Trust: Consistently ...

Apex Health Solutions

Certified Medical Coder

Houston, TX · On-site

$21.50 - $29.25/hr

Certified Medical Coder Certified Medical Coder role is responsible for reviewing, abstracting, and ... Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world ...

Apex Health Solutions

Certified Medical Coder

Houston, TX · On-site

$21.50 - $29.25/hr

Description Summary Certified Medical Coder role is responsible for reviewing, abstracting, and ... Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world ...

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

As of Jun 1, 2026, the average hourly pay for certified risk adjustment coder in the United States is $29.29, according to ZipRecruiter salary data. Most workers in this role earn between $21.88 and $29.09 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 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 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 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.

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What cities are hiring for Certified Risk Adjustment Coder jobs? Cities with the most Certified Risk Adjustment Coder job openings:
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What job categories do people searching Certified Risk Adjustment Coder jobs look for? The top searched job categories for Certified Risk Adjustment Coder jobs are:
Certified Risk Adjustment Coder jobs near you
Infographic showing various Certified Risk Adjustment Coder job openings in the United States as of May 2026, with employment types broken down into 100% Full Time. Highlights an 13% Physical, and 87% Remote job distribution, with an average salary of $60,920 per year, or $29.3 per hour.
Risk Adjustment Coder

Risk Adjustment Coder

Cano Health

Jupiter, FL • On-site

Full-time

Posted 2 days ago

Cano Health rating

7.6

Company rating: 7.6 out of 10

Based on 10 frontline employees who took The Breakroom Quiz

Job description

It's rewarding to be on a team of people that truly believe in making an impact!

We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.

Job Summary

The Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations.

Duties & Responsibilities

Essential Duties & Responsibilities

  • Review medical record information to identify all appropriate coding based on CMS HCC categories
  • Prepare the medical charts and track patient information via Excel spreadsheets.
  • Complete appropriate paperwork/documentation/system entry regarding claim/encounter information
  • Provide coding support, education and training related to, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards
  • Provide real time support and coordination with Primary Care Providers and Care Coordinators for MRA coding, HEDIS and STARS
  • Monitor coding changes to ensure that most current information is available
  • Work HCC suspect reports
  • Accurately code and submit encounters on a timely basis
  • Researching and addressing code questions for multiple provider offices as directed
  • Update the Director on the status on a weekly basis
  • Notifies Patient Experience Manager if annual wellness visits for patients have not been scheduled.
  • Travel to offices as necessary to complete on-site chart reviews
  • Performs post-audits on assigned offices and notifies office contact when codes are not addressed for provider review.
  • Support and participate in process and quality improvement initiatives.
  • Assists with billing claims as assigned.

Additional Duties & Responsibilities

  • Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Due to the nature of this position, it is understood that coding requirements are expected to change; therefore, participation in affiliated classes and individual efforts to maintain current knowledge of these changes is required.

Education & Experience

  • Two (2) years prior medical coding experience
  • Proficient in Microsoft Word and Excel
  • Strong organization and process management skills
  • Strong collaboration and relationship building skills
  • High attention to detail
  • Excellent written and verbal communication skills
  • Ability to learn new tasks and concepts
  • CPC or CRC Coding Certification

Knowledge, Skills & Proficiencies

  • Builds Trust: Consistently models and inspires high levels of integrity, lives up to commitments and takes responsibility for the impact of one's actions.
  • Pursues Excellence: Seeks out learning, strives to develop and expand personally, and continuously helps others upgrade their capability to contribute to the managed care plan.
  • Executes for Results: Effectively leverages resources to create exceptional outcomes, embraces changes and constructively resolves barriers and constraints.
  • Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that places emphasis on the success of the medical centers and insurance companies.

Job Requirements

Physical Requirements

This position works under usual office conditions. The employee is required to work at a personal computer as well as be on the phone for extended periods of time. Must be able to stand, sit, walk and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. Physical demands include ability to lift up to 50 lbs. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Tools & Equipment Used

Computer and peripherals, standard and customized software applications and tools, and usual office equipment.

Disclaimer

The duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. It is not designed to contain, or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of associates assigned to this job. This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

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