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Full Time Optum Health Coding Risk Adjustment Jobs in Birmingham, AL

Ryan Specialty

Catastrophe Risk Analyst

Birmingham, AL · On-site

$72K - $90K/yr

... health services and more. The target salary range for this position is $72,000.00 - $90,000.00 ... Full-time roles are eligible for bonuses and benefits. For additional information on Ryan Specialty ...

Ryan Specialty

Catastrophe Risk Analyst

Birmingham, AL

$72K - $90K/yr

... health services and more. The target salary range for this position is $72,000.00 - $90,000.00 ... Full-time roles are eligible for bonuses and benefits. For additional information on Ryan Specialty ...

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All JobsOptum Health Coding Risk Adjustment JobsFull Time Optum Health Coding Risk Adjustment JobsFull Time Optum Health Coding Risk Adjustment Jobs in Birmingham, AL

Full Time Optum Health Coding Risk Adjustment information

See Birmingham, AL salary details

$14

$24

$35

How much do full time optum health coding risk adjustment jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for full time optum health coding risk adjustment in Birmingham, AL is $24.70, according to ZipRecruiter salary data. Most workers in this role earn between $20.29 and $27.69 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a full time Optum Health coding risk adjustment professional?

To excel in a Full Time Optum Health Coding Risk Adjustment role, you need a solid understanding of medical coding guidelines, risk adjustment models (such as HCC), and typically a certification like CPC or CRC. Proficiency with coding software, electronic health records (EHRs), and risk adjustment analytics platforms is crucial. Attention to detail, analytical thinking, and effective communication help ensure accuracy and collaboration in documentation and reporting. These skills are vital for optimizing compliant coding, improving patient outcomes, and supporting accurate reimbursement in value-based care environments.

What is a full time Optum Health coding risk adjustment?

A Full Time Optum Health Coding Risk Adjustment job involves reviewing medical records and coding data to ensure accurate risk adjustment for health plan members. Employees in this role typically analyze clinical documentation, assign diagnostic codes, and support compliance with regulatory requirements. Their work ensures that health plans receive appropriate reimbursement by capturing the complexity and severity of patient conditions. This role is essential to maintaining data integrity and supporting overall healthcare quality initiatives.

What is the difference between Full Time Optum Health Coding Risk Adjustment vs Full Time Medical Coder?

AspectFull Time Optum Health Coding Risk AdjustmentFull Time Medical Coder
CertificationsCPR, CPC, or CCS often preferredCPR, CPC, or CCS typically required
Work EnvironmentHealthcare insurance, risk adjustment teamsHospitals, clinics, outpatient facilities
Industry UsageHealth insurance, risk managementHealthcare providers, hospitals
Job FocusRisk adjustment coding, data analysisMedical record coding, billing

Full Time Optum Health Coding Risk Adjustment roles focus on risk adjustment coding within health insurance companies, requiring knowledge of risk models and specific certifications. Full Time Medical Coders primarily work in healthcare facilities, concentrating on accurate medical record coding for billing. While both roles involve coding, their environments and focus areas differ significantly.

What are some common challenges faced by full time Optum Health coding risk adjustment professionals, and how can they be addressed?

Professionals in Full Time Optum Health Coding Risk Adjustment roles often encounter challenges such as keeping up with frequent updates to coding guidelines, managing high volumes of complex patient data, and ensuring accuracy under tight deadlines. Staying current with ongoing training, leveraging available coding support resources, and collaborating closely with clinical teams can help address these challenges. Additionally, using advanced coding tools and regularly participating in team meetings can improve both accuracy and workflow efficiency.
What are the most commonly searched types of Optum Health Coding Risk Adjustment jobs in Birmingham, AL? The most popular types of Optum Health Coding Risk Adjustment jobs in Birmingham, AL are:
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Full Time Optum Health Coding Risk Adjustment jobs near you

Clinical Documentation Specialist Outpatient

Children's of Alabama

Birmingham, AL • On-site

$32.50 - $43.75/hr

Full-time

Re-posted 12 days ago

Children's Of Alabama rating

6.5

Company rating: 6.5 out of 10

Based on 41 frontline employees who took The Breakroom Quiz

719th of 1,058 rated hospitals

Job description

In Clinical Documentation Integrity at Main Campus Lee Building
Work schedule will be Full-time on the Day Shift, Monday-Friday.
Summary:
The Outpatient Clinical Documentation Integrity (CDI) Specialist Nurse will provide clinically based reviews of outpatient medical records to assess and procure accurate, complete, and compliant documentation of the patients' visit encounter. The goal is to facilitate clinically appropriate physician and other clinician documentation of all patient conditions, treatments, and interventions to accurately reflect quality of care, severity of illness, risk of morality and risk adjustment factor to support correct coding, reimbursement, and quality initiatives. The goal of CDI outpatient reviews is to facilitate clinically appropriate physician/ clinician documentation of all patient conditions, treatments, and interventions to accurately reflect quality of care, severity of illness and risk of morality and risk adjustment factor to support correct coding, reimbursement, and quality initiatives. This role will work closely with all levels of leadership, subject matter experts, and operational stakeholders to remain compliant with state and federal regulatory codes and guidelines.
Other information:
Minimum Requirements
• Registered Nurse (RN) preferred
• Current RN or LPN Licensure in the State of Alabama required
Experience
• At least five years of nursing experience required (3 of these years must be in acute or intensive care setting), prefer pediatric experience. Will consider CDI experience in lieu of pediatric experience.
Licensures, Certifications, and/or Registries
• CCDS and/or Coding certification (ex. CPC) highly desired or willingness to complete after employment.
Credentials with Equivalent Qualifications:
Essential:
* Registered Nurse AL Single State or any of the following equivalent qualifications below:
- Registered Nurse AL NLC Multi State
- Registered Nurse Non-AL NLC Multi State
Nonessential:
* Certified Coding Specialist or Certified Coding Associate
Education with Equivalent Qualifications:
Essential:
* Bachelor of Science Nursing in Nursing or Associate of Science Nursing in Nursing
Experience with Equivalent Qualifications:
Essential:
* 5 Years job experience as Staff Level with specialization in the field of Nursing Acute
The Clinical Documentation Integrity (CDI) department plays a key role within the Revenue Cycle by ensuring the accuracy and integrity of clinical documentation and related processes. The department encompasses several specialized areas: Inpatient and Outpatient CDI, Infusion Prior Authorizations, Medical Audit, and Medicaid Screening. Each area is staffed by experienced nurses who review medical records for various clinical and regulatory purposes. Inpatient and Outpatient CDI Nurses conduct concurrent and retrospective reviews of medical records to ensure documentation accurately reflects the patient's clinical status, severity of illness, and treatments. Their work supports appropriate coding, reimbursement, and compliance, while also providing ongoing documentation education to physicians and clinical staff. Infusion Prior Authorization Nurses manage prior authorization requests for outpatient infusions, including those requiring peer-to-peer reviews or appeals. They collaborate closely with Billing on denials and appeals to support timely patient care and reimbursement. Medical Audit Nurses perform chart audits to ensure hospital charges are appropriate and compliant. They identify billing trends, correct discrepancies, and support hospital departments with charge integrity. Medicaid Screening Nurses focus on EPSDT and Interperiodic Screenings for patients with Medicaid coverage. Their detailed reviews ensure compliance with state and federal Medicaid regulations. Together, these teams support clinical excellence, regulatory compliance, and financial sustainability through comprehensive documentation and review processes.

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About Children's of Alabama

Sourced by ZipRecruiter

Since 1911, Children’s of Alabama has provided specialized medical care for ill and injured children. Ranked among the best children’s hospitals in the nation by U.S. News & World Report, Children’s serves patients from every county in Alabama and nearly every state. With more than 3.5 million square feet, it is one of the largest pediatric medical facilities in the United States. Children’s offers inpatient and outpatient services at its Russell Campus on Birmingham’s historic Southside with additional specialty services provided at Children’s South, Children’s on 3rd and in Huntsville and Montgomery. Primary medical care is provided in more than a dozen communities across central Alabama. Children’s is the only health system in Alabama dedicated solely to the care and treatment of children. It is a private, not-for-profit medical center that serves as the teaching hospital for the University of Alabama at Birmingham (UAB) pediatric medicine, surgery, psychiatry, research and residency programs. The medical staff consists of UAB faculty and Children’s full-time physicians as well as private practicing community physicians. Our staff is committed to providing the finest pediatric healthcare to all children. We built our legacy on our core values of trust, teamwork, compassion, innovation and commitment. We know that every time we come through these doors we will live up to our high standards as we work to make a difference in children's lives. You've chosen a career that’s all about care. If you want to make a difference the life of children and their families, if you want to advance in your profession, if you appreciate good benefits, and want to work with outstanding medical professionals in a variety of areas, then Children’s of Alabama is where you belong.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Birmingham, AL, US

Year founded

1911

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