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Freelance Remote Risk Adjustment Coder Jobs in Philadelphia, PA

Berkley

Claims Analyst

Trenton, NJ · Remote

$70K - $80K/yr

Company Details Berkley Accident and Health is a risk management company that designs innovative ... This position can either be fully remote (if not within commutable distance to the office) or based ...

Berkley

Claims Analyst

Trenton, NJ · Remote

$70K - $80K/yr

Berkley Accident and Health is a risk management company that designs innovative solutions to ... This position can either be fully remote (if not within commutable distance to the office) or based ...

RELX

Senior Technical Consultant

Philadelphia, PA · Remote

$114K - $190K/yr

About LexisNexis Risk Solutions LexisNexis Risk Solutions harnesses the power of data ... Occasional travel may be required Location Remote - US Requirements * Minimum 5 years of total ...

Corvel

Senior Claims Specialist

Norristown, PA · Remote

$61K - $98K/yr

This role is available for both remote and hybrid work arrangements. ESSENTIAL FUNCTIONS ... The level may impact the salary range and these adjustments would be clarified during the offer ...

3B Staffing LLC

Data Scientist

Cherry Hill, NJ · Remote

Remote Duration 4-6 months Advanced SAS programming (Base, Macro, SQL) in clinical trials with RBQM ... The RBQM Data Scientist supports central monitoring and risk-based quality management (RBQM) for ...

BAI

Software Engineer

Philadelphia, PA · On-site +1

$75K - $95K/yr

... risk management functions and BAI's knowledge in serving the retail banking and regulatory ... Participate in code reviews, technical guidance, and knowledge sharing. * Participate in efforts to ...

Certa

Engagement Manager

Wilmington, DE · Remote

... code platform to onboard, assess, and monitor their vendors, suppliers, and partners across risk ... Certa is a remote-first company and we hire globally. We believe strongly in each team member ...

Lancesoft INC

Senior Data Scientist

Titusville, NJ · Remote

$65 - $68/hr

... SUBMIT CODING EXAMPLES WITH RESUMES or they will be rejected out * Role can be HYBRID or REMOTE ... and risk evaluations, coordinate verification/validation activities, and compile evidence for ...

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All JobsRisk Adjustment Coder JobsFreelance Remote Risk Adjustment Coder JobsFreelance Remote Risk Adjustment Coder Jobs in Philadelphia, PA

Freelance Remote Risk Adjustment Coder information

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How much do freelance remote risk adjustment coder jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for freelance remote risk adjustment coder in Philadelphia, PA is $22.63, according to ZipRecruiter salary data. Most workers in this role earn between $18.17 and $24.28 per hour, depending on experience, location, and employer.

What are Freelance Remote Risk Adjustment Coders?

Freelance Remote Risk Adjustment Coders are healthcare professionals who work independently from various locations to review medical records and assign codes that reflect patients’ health conditions and treatments, focusing on risk adjustment models. Their primary role is to ensure accuracy in coding so that healthcare organizations receive appropriate reimbursement and maintain compliance with regulatory standards. These coders typically work on a contract basis, using secure digital platforms to access records and submit their coding work. They must be highly knowledgeable in ICD-10-CM coding guidelines, risk adjustment methodologies (such as HCC), and HIPAA regulations.

What are the key skills and qualifications needed to thrive as a Freelance Remote Risk Adjustment Coder, and why are they important?

Thriving as a Freelance Remote Risk Adjustment Coder requires deep knowledge of medical coding (especially ICD-10-CM), risk adjustment models, and compliance standards, typically verified by certifications like CRC, CPC, or CCS. Proficiency with coding software, EHR systems, and secure remote work platforms is essential for accurate and efficient coding. Strong attention to detail, self-motivation, and reliable communication are vital soft skills for managing independent workloads and collaborating with clients remotely. These abilities ensure accurate risk score calculations, regulatory compliance, and successful client relationships in a virtual work environment.

How do Freelance Remote Risk Adjustment Coders typically manage communication and workflow with healthcare clients and team members?

Freelance Remote Risk Adjustment Coders commonly use secure online platforms and project management tools to receive assignments, submit coded charts, and communicate with healthcare providers or project managers. Maintaining clear and prompt communication via email or dedicated messaging systems is crucial to clarify documentation, resolve coding queries, and ensure deadlines are met. Coders must be proactive in scheduling regular check-ins and staying updated on client-specific guidelines, as workflows can be fast-paced and require strong organizational skills. Collaboration often involves working independently but also participating in virtual meetings or training sessions to stay aligned with team quality standards.
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Freelance Remote Risk Adjustment Coder jobs near you
Claims Analyst

Claims Analyst

Berkley

Trenton, NJ • Remote

$70K - $80K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 21 days ago

Job description

Company Details

Berkley Accident and Health is a risk management company that designs innovative solutions to address the unique challenges of each client. With our entrepreneurial culture and a strong emphasis on analytics, we can help employers better manage their risk. We offer a broad range of products, including employer stop loss, benefit captives, provider stop loss, HMO reinsurance, and specialty accident. The key to Berkley's success is our nimble approach to risk - our ability to quickly understand, think through, and devise a plan that addresses each client's challenges, coupled with the strong backing of a Fortune 500 company. Our parent company, W. R. Berkley Corporation, is one of the largest and best managed property/casualty insurers in the United States.

#LI-AV1  #LI-Remote

The company is an equal employment opportunity employer.

Responsibilities

As a Stop Loss Claims Auditor (a.k.a. "Claims Analyst"),  you'll perform quality review and evaluation of all claim submissions received and logged into our claims system to determine whether the amount requested is eligible for reimbursement.

This position can either be fully remote (if not within commutable distance to the office) or based in one of our offices:

  • Hamilton Square, NJ
  • West Hartford, CT
  • Marlborough, MA
  • Harleysville, PA

We offer hybrid work schedule with 4 days in the office; and 1 day remote where it makes sense to do so.

What you can expect:

  • Culture of innovation, teamwork, supportive colleagues and leaders willing to invest in talent
  • Internal mobility opportunities 
  • Visibility to senior leaders and partnership with cross functional teams
  • Opportunity to impact change
  • Benefits - competitive compensation, paid time off, comprehensive wellness benefits and programs, employer funded health savings account, profit sharing, 401k, paid parental leave, employee stock purchase plan, tuition assistance and professional continuing education

We'll count on you to: 

  • Process an average of 5 to 7 claims per day
  • Maintain a processing accuracy of 99% or better
  • Determine, on a timely basis, the eligibility of assigned claim by applying the appropriate contractual provisions to the medical facts and specifications of the claim
  • Review and adjudicate claims within approved authority limits
  • Maintain assigned claim block and assist other team members while meeting departmental guidelines
  • Document rationale of claim decisions based on review of the contractual provisions, plan specifications and the analysis of medical records, etc.
  • Elevate issues to next level of supervision, as appropriate
  • Other duties as assigned
Qualifications

What you need to have:

  • 3-5+ years stop loss claims experience
  • Prior experience handling first dollar payer insurance (medical healthcare claims)
  • Experience with medical billing practices, CPT codes, revenue codes, and/or universal billing
  • Ability to use mathematics to adjudicate claims
  • Detail oriented with a high degree of accuracy and ability to multitask
  • Strong problem solving, decision-making, reporting and analytical skills
  • Must possess good judgment and work effectively with internal business areas, peers and co-workers
  • Demonstrated proficiency in Microsoft Office software 

What makes you stand out:

  • Prior experience handling stop loss claims at the reinsurance level (medical healthcare claims)
  • Ability to work independently, prioritize, organize and assign own work to meet deadlines
  • Ability to accept changing priorities with a minimum of disruption
Additional Company DetailsWe do not accept any unsolicited resumes from external recruiting firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees including: Base Salary Range: $70,000 - $80,000 Benefits include: Health, dental, vision, dental, life, disability, wellness, paid time off, 401(k) and generous profit-sharing plan The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.Sponsorship DetailsSponsorship not Offered for this RoleEmployment Type: OTHER

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