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Certified Risk Adjustment Coder Jobs (NOW HIRING)

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82.72K - $108.57K/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 ...

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82.72K - $108.57K/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 ...

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82.72K - $108.57K/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 ...

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82.72K - $108.57K/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 ...

Community Care Cooperative

Risk Coder

Boston, MA · On-site

$50.22K - $57.75K/yr

The Certified Risk Coder has experience in risk adjustment, outpatient primary care and/or behavioral health condition coding, billing compliance, and coding quality assurance protocols. The person ...

Mass Advantage

Manager, Risk Adjustment

Worcester, MA · On-site

CRC (Certified Risk Adjustment Coder), CPC, or CCS certification preferred. * 7+ years in Medicare Advantage risk adjustment, with at least 3 years in a plan-side role (not solely provider-side or ...

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

As of Jun 2, 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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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 91% Full Time, and 9% Part Time. Highlights an 89% Physical, 2% Hybrid, and 9% Remote job distribution, with an average salary of $60,920 per year, or $29.3 per hour.
Certified Risk Adjustment Coder (CRC), Senior Associate

Certified Risk Adjustment Coder (CRC), Senior Associate

Ankura Consulting Group, LLC

Washington, DC • On-site

$85K - $200K/yr

Full-time

Posted 10 days ago

Job description

Ankura is a team of excellence founded on innovation and growth.
Practice Overview:
Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest and most prominent US health care providers, payers, and law firms.
Role Overview:
Our Sr. Associates use their experience and knowledge related in coding, revenue cycle and clinical operations, along with their project management capabilities, to contribute to complex investigations, whistleblower lawsuits, internal investigations, payer/provider disputes, and acquisition due diligence, among others.
Responsibilities:
  • Review, analyze, and code diagnoses based on information in a patient's medical record according to specific guidelines for each project.
  • Evaluate compliance with established ICD-10 CM, third party reimbursement policies, regulations and accreditation guidelines.
  • Communicate effectively with internal and external stakeholders according to project requirements
  • Works with Project Managers to understand client needs and develop project work plans accordingly
  • Understands Healthcare Compliance concepts, issues, and how to research and access regulatory guidelines and reference materials
  • Drafts clear and concise analyses of medical record review and coding findings
  • Ensures successful completion of project deliverables as assigned and within the desired timeframe
  • Works collaboratively with Ankura team members focusing on building and maintaining internal and external client and counsel relationships
  • Identifies opportunities for cross practice collaboration
  • Proven writing and presentation skills and has a keen sense of attention to detail
  • Communicates findings of concern with the team and Project Manager as they are identified
  • Can independently deliver work and seeks to gain additional opportunities for development in a variety of risk adjustment related areas.

Qualifications:
  • Certified in Risk Adjustment Coding (CRC) with at least five (5) recent years of experience in HCC/Risk Adjustment and/or RADV Audit Methodology
  • Associate's or Bachelor's degree preferred, but not required
  • Strong understanding of clinical terminology, disease processes, anatomy and pharmacology.
  • Intermediate to advanced understanding of in claims processing procedures, state and federal regulations, and Medicare Part D requirements.
  • Excellent written and verbal communication skills, ability to work in a remote environment, and time management skills.
  • Prior success in managing small projects and teams and able to Ability to be able work on multiple client projects simultaneously, if needed.
  • Ability to work in a fast-paced environment while maintaining high quality
  • Proficient in Excel, Word, and PowerPoint and able to draft reports and presentations and present findings
  • Understands the importance of attorney-client privileged and confidential communication
  • Willingness to travel when needed
  • Willingness to perform a variety of skill based tasks related to risk adjustment work
  • Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.

For individuals assigned and/or hired to work in California, Colorado, or New York, Ankura is required to include a reasonable estimate of the compensation range for this role. This compensation range is specific to the said markets and considers a broad range of factors including but not limited to skill sets, experience and training, licensure and certifications, and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. The range does not include additional benefits outside of salary. At Ankura, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each role. A reasonable estimate of the current base pay range is between $85,000 to $200,000; this range is not a promise of a particular wage.
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Ankura is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability. Equal Employment Opportunity Posters, if you have a disability and believe you need a reasonable accommodation to search for a job opening, submit an online application, or participate in an interview/assessment, please email accommodations@ankura.com or call toll-free +1.312-583-2122. This email and phone number are created exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only messages left for this purpose will be returned. Messages left for other purposes, such as following up on an application or technical issues unrelated to a disability, will not receive a response.

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