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Entry Level Risk Adjustment Coder Jobs in Gilbert, AZ

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

The Associate, Risk Adjustment Auditor conducts internal and external quality audits ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Aledade

Clinical Risk Educator, Remote

Phoenix, AZ

Current medical coding certification such as Certified Professional Coder (CPC), Certified Coding Specialist - Physician-based (CCS-P), Certified Risk Adjustment Coder (CRC), Certified Clinical ...

Aledade

Clinical Risk Educator, Remote

Phoenix, AZ · Remote

Current medical coding certification such as Certified Professional Coder (CPC), Certified Coding Specialist - Physician-based (CCS-P), Certified Risk Adjustment Coder (CRC), Certified Clinical ...

Arizona Priority Care

Nurse Practioner

Chandler, AZ

Demonstrates knowledge and proficiency in understanding key elements of Risk Adjustment Factor (RAF ... diagnosis codes. * Educates and guides patients on disease prevention and health promotion ...

Arizona Priority Care

Nurse Practioner

Chandler, AZ

Demonstrates knowledge and proficiency in understanding key elements of Risk Adjustment Factor (RAF ... diagnosis codes. * Educates and guides patients on disease prevention and health promotion ...

Suvida

Specialist, Quality

Phoenix, AZ · On-site

... Risk Adjustment experience in supplemental data and chart reviews * Knowledge of CMS STARS program * Must have a basic understanding of billing and claims coding * Experience reviewing Electronic ...

New

AIG

Senior Underwriting Assistant

Scottsdale, AZ · On-site

This role assists the underwriters by screening risk offerings and with pre and post-binding ... Performs quality control of adjustments prior to underwriting review; documents discrepancies and ...

AIG

Senior Underwriting Assistant

Scottsdale, AZ · On-site

This role assists the underwriters by screening risk offerings and with pre and post-binding ... Performs quality control of adjustments prior to underwriting review; documents discrepancies and ...

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Entry Level Risk Adjustment Coder information

See Gilbert, AZ salary details

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$27

$43

How much do entry level risk adjustment coder jobs pay per hour?

As of Jun 19, 2026, the average hourly pay for entry level risk adjustment coder in Gilbert, AZ is $27.40, according to ZipRecruiter salary data. Most workers in this role earn between $18.94 and $34.52 per hour, depending on experience, location, and employer.

What is an Entry Level Risk Adjustment Coder job?

An Entry Level Risk Adjustment Coder reviews medical records to identify and assign accurate diagnosis codes for risk adjustment purposes. Their work ensures healthcare organizations receive appropriate reimbursement based on patient health conditions. They typically use ICD-10-CM codes and follow guidelines from CMS and other regulatory bodies. This role requires strong attention to detail, knowledge of medical terminology, and an understanding of risk adjustment models. Entry-level coders may work in various healthcare settings, including insurance companies, hospitals, or coding firms.

What are the key skills and qualifications needed to thrive in the Entry Level Risk Adjustment Coder position, and why are they important?

To thrive as an Entry Level Risk Adjustment Coder, you need a strong understanding of medical terminology, anatomy, and ICD-10-CM coding guidelines, typically supported by completion of a coding training program or relevant coursework. Familiarity with coding software, electronic medical records (EMR) systems, and coding certification such as CPC or CRC is often preferred. Attention to detail, analytical thinking, and effective communication are essential soft skills for this role. These skills and qualifications ensure the accurate coding of diagnoses for risk adjustment, compliance with regulations, and contribute to optimal healthcare reimbursement.

What does a typical workday look like for an entry level risk adjustment coder?

A typical day for an entry level risk adjustment coder involves reviewing patient medical records to identify and assign appropriate diagnostic codes based on clinical documentation. You’ll use specialized coding software and electronic health record systems to ensure accuracy and compliance with federal guidelines. Collaboration with senior coders, team leads, and occasionally clinicians is common when clarification or additional documentation is needed. Most entry level coders work in an office or remote environment and spend much of their day analyzing records, updating databases, and participating in training sessions to stay current on coding updates.

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Entry Level Risk Adjustment Coder jobs near you
Auditor, Risk Adjustment

Auditor, Risk Adjustment

Oscar Health

Tempe, AZ • Remote

$82K - $108K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 20 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

228th of 261 rated insurance

Job description

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Associate, Risk Adjustment Auditor conducts internal and external quality audits. Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and identified clinical documentation improvement opportunities. You will work with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs.

You will report into the Manager, Risk Adjustment.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

  • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts.
  • Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation
  • Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented.
  • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards.
  • Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits.
  • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process.
  • Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business.
  • Manage the implementation process improvements that will maximize risk adjustment factor increases.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Bachelor's degree in a relevant field of study or commensurate work experience.
  • 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) experience

Bonus points:

  • Certified Risk Adjustment Coder (CRC) or similar certification
  • Experience coding in a variety of different Electronic Medical Record (EMR) systems.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.