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Medicare Risk Adjustment Coder Jobs (NOW HIRING)

Strive Health

Risk Adjustment Coder

Denver, CO · Remote

$27.88 - $32.21/hr

What You'll Do The Coder, Risk Adjustment Coding is responsible for supporting the Strive ... Extensive knowledge of documentation and coding guidelines established by the Center for Medicare ...

Strive Health

Risk Adjustment Coder

Denver, CO · On-site

$19.25 - $25.75/hr

What You'll Do The Coder, Risk Adjustment Coding is responsible for supporting the Strive ... Extensive knowledge of documentation and coding guidelines established by the Center for Medicare ...

Boston Medical Center

Risk Adjustment Coder

$19.25 - $25.50/hr

The Risk Adjustment Coder determines the appropriate ICD10-CM diagnoses codes based on clinical documentation that follows the Official Guidelines for Coding and Reporting and Risk Adjustment ...

Msmc

Certified Risk Adjustment Coder Senior

Campus, IL

$22 - $30/hr

Utilizes analytics, identifies and target IMED physicians for Medicare Risk Adjustment training and documentation/coding resources. * Other duties as assigned. Qualifications * License/Registration ...

Msmc

Certified Risk Adjustment Coder Senior

Miami Beach, FL

$22.25 - $30.25/hr

Utilizes analytics, identifies and target IMED physicians for Medicare Risk Adjustment training and documentation/coding resources. * Other duties as assigned. Qualifications * License/Registration ...

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How much do medicare risk adjustment coder jobs pay per hour?

As of Jun 1, 2026, the average hourly pay for medicare risk adjustment coder in the United States is $22.42, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $24.04 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Medicare Risk Adjustment Coder, and why are they important?

To thrive as a Medicare Risk Adjustment Coder, you need strong knowledge of ICD-10-CM coding guidelines, risk adjustment methodologies, and compliance standards, typically validated by a coding certification such as CPC or CRC. Familiarity with electronic health record (EHR) systems, coding software, and risk adjustment platforms is essential. Attention to detail, analytical thinking, and effective communication are vital soft skills for accurate code assignment and collaboration with healthcare providers. These skills ensure precise risk score calculations, regulatory compliance, and optimal reimbursement for healthcare organizations.

What are some common challenges Medicare Risk Adjustment Coders face when ensuring accurate documentation for risk adjustment purposes?

Medicare Risk Adjustment Coders often encounter challenges such as incomplete or inconsistent provider documentation, which can make it difficult to capture all relevant diagnoses for accurate risk adjustment. They must stay current with ever-changing CMS guidelines and coding updates, requiring continual education and attention to detail. Additionally, collaboration with providers is essential to clarify documentation and ensure compliance, which can sometimes be challenging due to time constraints or varying levels of coding knowledge among clinicians.

What is a Medicare Risk Adjustment Coder?

A Medicare Risk Adjustment Coder is a healthcare professional responsible for reviewing medical records and assigning diagnostic codes to ensure accurate risk adjustment for Medicare Advantage plans. Their work helps determine the level of reimbursement health plans receive from Medicare based on the health status and risk profile of enrolled patients. Coders must have a strong understanding of ICD-10 coding, clinical documentation, and CMS regulations. They play a vital role in compliance and in ensuring that health plans receive appropriate funding for the care of their members.

What is the difference between Medicare Risk Adjustment Coder vs Medical Coder?

AspectMedicare Risk Adjustment CoderMedical Coder
CertificationsAHIMA or AAPC certifications, specialized in risk adjustmentAHIMA or AAPC certifications, general coding credentials
Work EnvironmentHealthcare organizations, insurance companies, risk adjustment teamsHospitals, clinics, physician offices
Industry UsageFocused on Medicare Advantage and risk adjustment programsBroad medical billing and coding across specialties

Medicare Risk Adjustment Coders specialize in coding for Medicare Advantage plans and risk adjustment models, requiring specific knowledge of CMS guidelines. Medical Coders have a broader scope, focusing on general medical billing and coding across various healthcare settings. While both roles require coding certifications, Medicare Risk Adjustment Coders focus on risk scores and Medicare-specific data, making their expertise more specialized.

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What job categories do people searching Medicare Risk Adjustment Coder jobs look for? The top searched job categories for Medicare Risk Adjustment Coder jobs are:
Medicare Risk Adjustment Coder jobs near you
Infographic showing various Medicare Risk Adjustment Coder job openings in the United States as of May 2026, with employment types broken down into 41% Full Time, and 59% Part Time. Highlights an 72% Physical, 24% Hybrid, and 4% Remote job distribution, with an average salary of $46,638 per year, or $22.4 per hour.
Medicare Risk Adjustment Coding Manager

Medicare Risk Adjustment Coding Manager

Village Care

Manhattan, NY • On-site

$102.55K - $115.37K/yr

Full-time

Posted 12 days ago

Job description

Position: Medicare Risk Adjustment Coding Manager
Location: Remote (Must Reside in NY/NJ/CT)
Work Schedule: Monday - Friday, 9:00am - 5:00pm
Compensation: $102,549.17 - $115.367.82 Annual Salary
Join VillageCare as a Full-Time Medicare Risk Adjustment Coding Manager and enjoy the thrill of playing a vital role in healthcare's future while working from the comfort of your home. This position offers unparalleled flexibility, allowing you to balance personal and professional commitments seamlessly. Envision being part of a team that prioritizes excellence and customer-centric solutions in the ever-evolving health care landscape, all while residing in the vibrant city of New York, NY. As a key player in our organization, you will lead initiatives that directly impact patient care and financial outcomes. The compensation for this role ranges from $102,549.17 to $115,367.82, reflecting the importance we place on your expertise and leadership.
If you are a smart problem solver with a passion for integrity and high-performance culture, consider applying to be a part of our forward-thinking team.
VillageCare: Our Mission
VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.
Are you excited about this Medicare Risk Adjustment Coding Manager job?
The Risk Adjustment Coding Manager at VillageCare plays a crucial role in enhancing healthcare quality and operational efficiency. This position is responsible for coordinating Risk Adjustment and Quality coding operations, emphasizing documentation integrity across both areas. The manager will oversee retrospective and prospective chart review programs while supervising the Risk Adjustment coding staff and managing day-to-day vendor operations. Acting as the operational bridge between Risk Adjustment and the HEDIS/Quality abstraction team, the manager ensures that all medical record interactions are utilized effectively for Hierarchical Condition Category (HCC) accuracy and closing quality gaps.
By eliminating redundant provider outreach and maximizing the clinical value of each chart interaction, this role aims to achieve year-over-year improvements in Risk Adjustment accuracy, Risk Adjustment Factor (RAF) performance, and STARs quality measure outcomes, directly impacting patient care and organizational success.
Requirements for this Medicare Risk Adjustment Coding Manager job
To excel as the Risk Adjustment Coding Manager at VillageCare, candidates must possess a robust set of skills and qualifications. A CPC, CPMA, CRC, CCS-P, CCS, RHIA, or RHIT certification is essential, along with at least five years of experience in Medicare Risk Adjustment coding and familiarity with RADV audits. Proficiency in HEDIS measure specifications and quality gap closure operations is highly preferred. Candidates should have a strong command of ICD-10 and CPT codes, as well as experience using electronic medical record systems.
Excellent communication skills are vital for effectively collaborating within the department and with cross-functional teams. Additionally, a Bachelor's degree in Business Administration, Finance, or a relevant field, or equivalent work experience, is required, ensuring that the candidate is well-equipped to navigate the complexities of healthcare coding and operational management.
Knowledge and skills required for the position are:
  • CPC /CPMA/ CRC/ CCS-P/ CCS/ RHIA or RHIT certification.
  • Experience with HEDIS measure specifications and quality gap closure operations preferred
  • 5+ years of Medicare Risk Adjustment coding including work on RADV audits
  • Previous experience using electronic medical record systems.
  • Strong knowledge of ICD-10 and CPT codes
  • Excellent communication skills to facilitate working with teammates within the department and cross-functional teams.
  • Bachelor's degree in Business Administration, Finance or relevant field OR equivalent work experience required
Are you ready for an exciting opportunity?
If you have these qualities and meet the basic job requirements, we'd love to have you on our team. Apply now using our online application!

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