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From Home Optum Health Coding Risk Adjustment Jobs

Vytwo

Risk Adjustment Coding Auditor

Prosper, TX · On-site

$25 - $28.50/hr

Risk Adjustment Coding Auditor Quantity of resources: 2 Duration: 6 months JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV'

Medix

Risk Adjustment Director

Scotts Valley, CA · On-site

$96.15 - $120.19/hr

... member health coding, managing financial impacts of risk scores, leading a team, and acting on ... Optimize Risk Adjustment Factor improvements through external vendors. * Partner with the Provider ...

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 ...

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · 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 ...

Oscar Health

Auditor, Risk Adjustment

Miami, FL · 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 ...

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From Home Optum Health Coding Risk Adjustment information

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

As of Jul 17, 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.

Does Optum allow remote work?

Optum Health Coding Risk Adjustment roles typically offer remote work options, allowing employees to perform their duties from home. These positions often require familiarity with coding software and adherence to healthcare privacy standards, with flexible schedules in many cases.

What is an Optum HCC coder job description?

An Optum HCC coder is responsible for reviewing and abstracting medical records to assign Hierarchical Condition Category (HCC) codes that reflect patient health status for risk adjustment. They ensure accurate coding in compliance with CMS guidelines, often using coding software and requiring knowledge of medical terminology and coding standards. The role typically involves remote work, attention to detail, and may require certification such as CPC or CCS.

How much can you make working from home as a medical coder?

Medical coders working from home, including those in risk adjustment roles like Optum Health Coding, typically earn between $40,000 and $70,000 annually, depending on experience, certifications, and workload. Advanced skills and certifications such as CPC or CCS can lead to higher pay, and remote positions often offer flexible schedules and the use of coding software tools.

Will a medical coder be replaced by AI?

Medical coders, including those specializing in risk adjustment for health plans, perform complex tasks that require understanding medical records and applying coding guidelines. While AI tools can assist with coding accuracy and efficiency, they are unlikely to fully replace human coders due to the need for clinical judgment and nuanced decision-making. Coders with skills in coding systems like ICD-10 and familiarity with electronic health records remain essential in the industry.
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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 July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, and 7% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% 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 • Remote

$42.79 - $48.75/hr

Other

Re-posted yesterday

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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