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From Home Optum Health Coding Risk Adjustment Jobs

Strive Health

Risk Adjustment Coder

Denver, CO · Remote

$27.88 - $32.21/hr

They will review assigned provider's documentation and coding from end to end, including proper ... health outcomes for patients and continuity of care. This role will report to the Manager, Risk ...

Village Care

Risk Adjustment Coding Manager

Manhattan, NY · On-site

$102K - $115K/yr

... in healthcare's future while working from the comfort of your home. This position offers ... The Risk Adjustment Coding Manager at VillageCare plays a crucial role in enhancing healthcare ...

Boston Medical Center

Risk Adjustment Coder

$19.25 - $25.50/hr

Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is required. Certification may include Certified Risk Adjustment ...

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... While your daily work will be completed from your home office, occasional travel may be required ...

EmblemHealth

Director, Risk Adjustment - Hybrid

New York, NY · On-site

$135K - $253K/yr

... code and submit diagnostic information from providers on EmblemHealth members enrolled in Medicare ... Manage the In-Home Assessment risk adjustment vendor program. * Manage team completing revenue ...

CareFirst

Senior Risk Adjustment Analyst

Baltimore, MD · Hybrid

The incumbent will be expected to work a portion of their week from home and a portion of their ... Develop tracking and monitoring mechanisms for all Risk Adjustment and Coding programs. Support ...

Point32health

Risk Adjustment Consultant

Canton, MA · On-site

Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated ... Must be able to work under normal office conditions and work from home as required. * Work may ...

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How much do from home optum health coding risk adjustment jobs pay per hour?

As of Jun 7, 2026, the average hourly pay for from home optum health coding risk adjustment in the United States is $21.50, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $22.84 per hour, depending on experience, location, and employer.

What is the difference between From Home Optum Health Coding Risk Adjustment vs From Home Optum Health Medical Coding?

AspectFrom Home Optum Health Coding Risk AdjustmentFrom Home Optum Health Medical Coding
CertificationsCCS, CPC, or RHIT/RHIACCS, CPC, or RHIT/RHIA
Work EnvironmentRemote, home-basedRemote, home-based
Industry UsageHealth insurance, risk adjustment programsHealthcare providers, hospital coding
Job FocusRisk adjustment coding for insurance accuracyClinical coding for medical records

While both roles involve medical coding from home, From Home Optum Health Coding Risk Adjustment focuses on coding for insurance risk adjustment programs, requiring specific risk adjustment knowledge. In contrast, From Home Optum Health Medical Coding emphasizes clinical coding for medical records, often in hospital or provider settings. Both roles require similar certifications and offer remote work, but their primary focus and industry applications differ.

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From Home Optum Health Coding Risk Adjustment jobs near you
Infographic showing various From Home Optum Health Coding Risk Adjustment job openings in the United States as of May 2026, with employment types broken down into 4% Full Time, and 96% Part Time. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $44,724 per year, or $21.5 per hour.
HEALTH CODER - HCC & RISK ADJUSTMENT

HEALTH CODER - HCC & RISK ADJUSTMENT

North East Medical Services

Burlingame, CA • On-site

$42.79 - $48.75/hr

Other

Posted 21 days ago

Job description

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance.
ESSENTIAL JOB FUNCTIONS:
  • HCC Coding and Risk Adjustment (RA) Program Support
    • Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
    • Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
    • Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
  • Provider Training and Clinical Documentation Improvement (CDI)
  • Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
  • Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
  • Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
  • Data Analysis and Reporting
    • Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
    • Generate reports and dashboards to track coding performance and documentation accuracy.
    • Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
  • Compliance and Continuous Improvement
    • Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
    • Assist in the development and implementation of internal coding policies and procedures.
    • Participate in quality improvement initiatives related to coding and documentation.
    • Performs other job duties as required by manager/supervisor

  • Education & Certification:
    • BS/BA Degree in Health Science or General Education is required.
    • Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
    • Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
  • Experience:
    • Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
    • Experience in provider education, clinical documentation improvement (CDI), and chart audits.
    • Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
  • Skills & Competencies:
    • Excellent communication, presentation, and interpersonal skills.
    • Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
    • Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
    • Proficiency in electronic health records (EHR) and coding software.
    • Strong analytical and problem-solving skills.

LANGUAGE:
  • Must be able to fluently speak, read and write English.
  • Fluency in other languages is an asset.

STATUS:
  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This a full-time position.

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