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Full Time Optum Health Coding Risk Adjustment Jobs in Philadelphia, PA

Monogram Health

Market Physician Executive

Trenton, NJ · Remote

... health outcomes by leveraging proprietary AI algorithms and a risk-based model. The MPE will ... risk adjustment. * Current state medical license without restrictions to practice and free of ...

County of Delaware, PA

Risk Manager

Media, PA · On-site

$75K - $98K/yr

The Risk Manager ensures compliance with applicable federal, Commonwealth of Pennsylvania, and ... to full-time employees including health care, dental, retirement, life insurance, holidays ...

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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 Philadelphia, PA

Full Time Optum Health Coding Risk Adjustment information

See Philadelphia, PA salary details

$15

$26

$38

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

As of Aug 10, 2026, the average hourly pay for full time optum health coding risk adjustment in Philadelphia, PA is $26.59, according to ZipRecruiter salary data. Most workers in this role earn between $21.83 and $29.86 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 Philadelphia, PA? The most popular types of Optum Health Coding Risk Adjustment jobs in Philadelphia, PA are:
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Full Time Optum Health Coding Risk Adjustment jobs near you

Clin Documentation Spec III - Remote

Cooper University Hospital

Camden, NJ • On-site, Remote

$70/hr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 24 days ago

Cooper University Health Care rating

7.5

Company rating: 7.5 out of 10

Based on 133 frontline employees who took The Breakroom Quiz

232nd of 887 rated healthcare providers

Job description

About Us
AtCooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development.
Discover why Cooper University Health Care is the employer of choice in South Jersey.
Short Description
  • Responsible for ensuring the overall quality and completeness of medical record documentation.
  • Facilitates modifications to clinical documentation through concurrent interaction with physicians, nursing staff, other patient caregiver and Health Information coding staff to support that appropriate reimbursement and clinical severity is captured for the level of service rendered to all inpatients.
  • Supports timely, accurate and complete documentation of clinical information used for measuring and reporting physician and hospital outcomes.
  • Educates all members of the patient care team on an ongoing basis.
  • Professional team player, able to communicate well with others on all levels.
  • Regular significant contacts with other personnel throughout and outside the hospital.
  • Contacts may be in person, by telephone or-through correspondence.
  • Flexible with a working knowledge of all areas of adult medicine.
  • Occasional lifting/carrying up to fifteen pounds, as well as reaching, stretching, stooping, bending, kneeling, crouching, standing, walking and pushing/pulling to move and file medical records alone or in carts.
  • Ability to sit for long periods of time, manual dexterity and mobility for extensive use of computer screen, keyboard, copy and facsimile machines, reader/printer and other office equipment.
  • Adequate to perform essential functions of the job with the type of judgments and potential consequences outlined above.

Experience Required
  • EPIC EHR
  • CDE ONE, Solventum
  • 5 years minimum experience as Clinical Documentation Specialist in an acute setting, preferably Level 1 Trauma Center.
  • CDI Subject matter expert for ALL PAYORS, all DRG groups (MS-DRG, APR-DRG, AP-DRG Elixhauser, risk variables)
  • PSI/HAC/HCC (Risk adjustment coding) knowledge/experience and Vizient Calculator

Education Requirements
Registered Nurse, any state. BSN or higher preferred or International medical graduate.
License/Certification Requirements
  • CCDS or CDIP
  • Registered Nurse, any state. BSN or higher preferred
  • Coding certification: CCS or CRC; CIC is an acceptable equivalent

Special Requirements
Essential mental abilities: excellent critical thinking skills, able to assess, evaluate and teach. Must be self governed, disciplined, and organized.
Requires excellent work ethic, analytical thinking, problem solving, excellent computer skills, excellent verbal and written communication with knowledge of email etiquette. Must be proficient in Word, Excel, PowerPoint and typing (60 WPM)
Salary Min ($)
USD $41.00
Salary Max ($)
USD $70.00

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