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Full Time Remote Risk Adjustment Coder Jobs in San Jose, CA

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Full Time Remote Risk Adjustment Coder information

See San Jose, CA salary details

$20

$25

$27

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

As of Aug 25, 2026, the average hourly pay for full time remote risk adjustment coder in San Jose, CA is $25.20, according to ZipRecruiter salary data. Most workers in this role earn between $21.11 and $26.78 per hour, depending on experience, location, and employer.

What is the difference between Full Time Remote Risk Adjustment Coder vs Full Time Remote Medical Coder?

AspectFull Time Remote Risk Adjustment CoderFull Time Remote Medical Coder
CertificationsRHIT, RHIA, CCS, CPCCPC, CCS, RHIT
Work EnvironmentRemote, healthcare insurance companies, risk adjustment teamsRemote, hospitals, clinics, healthcare facilities
Industry UsageHealth insurance, risk adjustment programsHospitals, clinics, healthcare providers
Job FocusAnalyzing diagnoses for risk scores, coding for risk adjustmentMedical record coding, billing, and documentation

The main difference is that Full Time Remote Risk Adjustment Coders focus on analyzing diagnoses to support risk scores for insurance reimbursement, often requiring specific certifications like RHIT or CCS. Full Time Remote Medical Coders handle general medical coding for billing and documentation, with certifications like CPC or CCS. Both roles are remote but serve different purposes within the healthcare industry.

What are the most commonly searched types of Remote Risk Adjustment Coder jobs in San Jose, CA?

The most popular types of Remote Risk Adjustment Coder jobs in San Jose, CA are:

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For Full Time Remote Risk Adjustment Coder jobs in San Jose, CA, the most frequently searched job titles are:

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The top searched job categories for Full Time Remote Risk Adjustment Coder jobs in San Jose, CA are:

What cities near San Jose, CA are hiring for Full Time Remote Risk Adjustment Coder jobs?

Cities near San Jose, CA with the most Full Time Remote Risk Adjustment Coder job openings:

Full Time Remote Risk Adjustment Coder jobs near you

HEALTH CODER - HCC & RISK ADJUSTMENT

NORTH EAST MEDICAL SERVICES

Burlingame, CA • Remote

$42.79 - $48.75/hr

Full-time

Re-posted 10 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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