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Entry Level Optum Health Coding Risk Adjustment Jobs

Regal Medical Group, Inc.

$33 - $36/hr

This position works to improve the quality of coding documentation and data in the medical record ... Health and Wellness: * Employer-paid comprehensive medical, pharmacy, and dental for employees

Regal Medical Group, Inc.

$25 - $27/hr

This position works to improve the quality of coding documentation and data in the medical record ... Health and Wellness: * Employer-paid comprehensive medical, pharmacy, and dental for employees

S & S Management

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HEDIS/Risk Adjustment Coordinator

Alhambra, CA · On-site

$22 - $24/hr

A HEDIS/Risk Adjustment Coordinator is a healthcare quality and data-management professional who ... coding guidelines. • Assist with audits conducted by health plans and regulatory agencies. • ...

S & S Management

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HEDIS/Risk Adjustment Coordinator

Alhambra, CA · On-site

$22 - $24/hr

A HEDIS/Risk Adjustment Coordinator is a healthcare quality and data-management professional who ... coding guidelines. • Assist with audits conducted by health plans and regulatory agencies. • ...

Lee Health

HCC Coding Educator

Fort Myers, FL · On-site +1

$27.57 - $35.84/hr

Associate's degree in health information management, nursing, healthcare administration or related field required. Experience: Minimum of 3 years' experience in HCC coding and risk adjustment.

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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.

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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 June 2026, with employment types broken down into 1% As Needed, 26% Full Time, 31% Part Time, 1% Temporary, 40% Contract, and 1% Nights. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution.
Certified Coder (Risk Adjustment Experience Required) - REMOTE

Certified Coder (Risk Adjustment Experience Required) - REMOTE

Molina Healthcare

Long Beach, CA • Remote

$19.84 - $38.69/hr

Full-time

Posted 29 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 192 frontline employees who took The Breakroom Quiz

144th of 262 rated insurance

Job description

JOB DESCRIPTION Job SummaryProvides support for medical coding activities, including ensuring that ICD-10 and CPT codes are reported accurately to maintain compliance, and minimize risk and denials. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
Performs on-going member medical chart reviews. Abstracts and reports ICD-10 and CPT diagnosis codes accurately and in compliance with established coding and billing principles - minimizing risk and denials.
Demonstrates understanding of current provider office billing practices - ensuring that diagnosis and CPT codes are submitted accurately.
Documents results/findings from chart reviews and provides feedback to leadership, providers and office staff.
Provides training and education to provider network regarding risk adjustment and coding updates related to risk adjustment.
Builds positive relationships between providers and the business by providing coding assistance as needed.
Facilitates administrative duties such as planning, chart reviews scheduling, medical records procurement, provider training and education.
Assists in coordination of management activities with other departments including finance, revenue analytics, claims, encounters and enterprise/plan medical directors.
Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks and participating in professional societies related to medical coding in the managed care industry.
Required Qualifications At least 2 years medical coding experience, or equivalent combination of relevant education and experience.
Certified Professional Coder (CPC).
Certified Coding Specialist (CCS).
Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge.
Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
Ability to effectively interface with staff, clinicians, and management.
Excellent verbal and written communication skills.
Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and all other customers.
Strong verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
Certified Risk Adjustment Coder (CRC).
Certified Professional Payer - Payer (CPC-P).
Certified Coding Specialist - Physician Based (CCS-P).
Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model.
Background in supporting risk adjustment management activities and clinical informatics.
Experience with risk adjustment data validation.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $19.84 - $38.69 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

What Molina Healthcare employees say

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Benefits

Hours and flexibility

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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