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Entry Level Optum Health Coding Risk Adjustment Jobs

Point32Health

Risk Adjustment Consultant

Canton, MA · On-site

Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated ... Support the Risk Adjustment department in efforts to assess additional diagnosis coding ...

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82.72K - $108.57K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82.72K - $108.57K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82.72K - $108.57K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82.72K - $108.57K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Point32Health

Risk Adjustment Consultant

Canton, MA · On-site

Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated ... Support the Risk Adjustment department in efforts to assess additional diagnosis coding ...

Cano Health

Risk Adjustment Coder

Jupiter, FL · On-site

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 ...

Point32health

Risk Adjustment Consultant

Canton, MA · On-site

Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated ... Support the Risk Adjustment department in efforts to assess additional diagnosis coding ...

Millennium Physician Group

OR · On-site

Under the direction of Burden of Illness department leadership, the Risk Adjustment Coding ... Collaborate with healthcare providers and other stakeholders to clarify documentation and ensure ...

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Entry Level Optum Health Coding Risk Adjustment information

What are the key skills and qualifications needed to thrive as an Entry Level Optum Health Coding Risk Adjustment specialist, and why are they important?

To thrive in an Entry Level Optum Health Coding Risk Adjustment role, you typically need a basic understanding of medical terminology, ICD-10 coding, and healthcare documentation, often supported by a Certified Professional Coder (CPC) or similar certification. Familiarity with coding software, electronic health record (EHR) systems, and risk adjustment methodologies is important for daily tasks. Attention to detail, analytical thinking, and effective communication are vital soft skills for ensuring coding accuracy and collaborating with healthcare providers. These skills and qualifications are essential to ensure precise risk adjustment coding, compliance with regulations, and the financial integrity of healthcare organizations.

What are the primary challenges faced by entry-level coders in Optum Health's risk adjustment team, and how can new hires successfully navigate them?

Entry-level coders in Optum Health's risk adjustment team often encounter challenges such as understanding complex medical terminology, accurately interpreting clinical documentation, and strictly adhering to coding guidelines. Additionally, adjusting to a fast-paced environment with productivity and quality targets can be demanding. New hires can succeed by participating in available training sessions, proactively seeking clarification from experienced team members, and regularly reviewing updated coding standards. Building strong communication with clinicians and fellow coders also helps ensure accuracy and efficiency in coding assignments.

What is an Entry Level Optum Health Coding Risk Adjustment position?

An Entry Level Optum Health Coding Risk Adjustment position is a role within Optum Health focused on reviewing medical records and accurately assigning diagnostic codes to ensure proper risk adjustment for healthcare plans. These professionals help ensure that health plans receive adequate funding based on the health status of their members, which is crucial for organizations participating in Medicare Advantage and other risk-adjusted programs. Entry-level employees in this field typically work under the supervision of more experienced coders, learning industry coding standards and guidelines such as ICD-10-CM. Strong attention to detail, understanding of medical terminology, and compliance with regulations are important aspects of this job.

What is the difference between Entry Level Optum Health Coding Risk Adjustment vs Entry Level Medical Coding Specialist?

AspectEntry Level Optum Health Coding Risk AdjustmentEntry Level Medical Coding Specialist
CertificationsCPR, CPC or equivalent preferredCPC or CCS certification often required
Work EnvironmentHealthcare insurance, payer organizations, risk adjustment teamsHospitals, clinics, outpatient facilities
Job FocusRisk adjustment coding for insurance reimbursement and risk managementClinical coding for medical procedures and diagnoses
Industry UsageHealth insurance, managed careHealthcare providers, hospitals

Entry Level Optum Health Coding Risk Adjustment roles focus on coding for insurance risk adjustment, requiring knowledge of payer guidelines. Entry Level Medical Coding Specialists primarily code clinical procedures and diagnoses for patient records. While both roles involve medical coding, the former emphasizes insurance and risk management, whereas the latter centers on clinical documentation. Understanding these differences helps job seekers target the right position based on their skills and career goals.

More about Entry Level Optum Health Coding Risk Adjustment jobs
What cities are hiring for Entry Level Optum Health Coding Risk Adjustment jobs? Cities with the most Entry Level Optum Health Coding Risk Adjustment job openings:
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Entry Level Optum Health Coding Risk Adjustment jobs near you
Infographic showing various Entry Level Optum Health Coding Risk Adjustment job openings in the United States as of May 2026, with employment types broken down into 1% As Needed, 83% Full Time, and 16% Part Time. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution.

Risk Adjustment Analyst

PCC MEDICAL HOLDINGS LLC

North Palm Beach, FL • On-site

$65K - $75K/yr

Full-time

Posted 7 days ago

Job description

Risk Adjustment Specialist – Primary Care
Location: Remote
Employment Type: Full-Time
Pay : $65K - $75K
About Us
Here at Physician Care Centers, we are a patient-centered primary care organization committed to delivering high-quality, value-based care. Our team partners with providers to improve patient outcomes while ensuring accurate clinical documentation and coding practices.
Position Overview
We are seeking a detail-oriented Risk Adjustment Specialist to support our value-based care initiatives. In this role, you will work closely with providers and clinical teams to ensure accurate documentation and coding of patient conditions, helping reflect the true complexity of our patient population.
What You’ll Do
  • Perform pre-visit and post-visit chart reviews to identify risk adjustment opportunities
  • Ensure accurate ICD-10-CM and HCC coding based on clinical documentation
  • Partner with providers to clarify diagnoses and improve documentation quality
  • Educate providers and staff on risk adjustment and coding best practices
  • Track and monitor Risk Adjustment Factor (RAF) scores and performance metrics
  • Support internal and external audits and ensure compliance with Centers for Medicare & Medicaid Services (CMS) guidelines
  • Stay current on coding updates and value-based care requirements
What We’re Looking For
  • 2+ years of experience in risk adjustment, medical coding, or primary care
  • Strong knowledge of ICD-10-CM and HCC coding
  • Certification such as CRC or CPC preferred
  • Experience working with electronic health records (EHRs)
  • Excellent attention to detail and analytical skills
  • Strong communication skills and ability to collaborate with providers
Why Join Us?
  • Competitive salary and benefits package
  • Opportunity to work in a growing value-based care environment
  • Collaborative and supportive team culture
  • Professional development and certification support