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Medicare Risk Adjustment Coder Jobs (NOW HIRING)

Vertek Staffing

HCC Risk Adjustment Coder

Franklin, TN · Remote

$18 - $24/hr

HCC / Risk Adjustment Coder - Remote Risk Adjustment / HCC Coding Experience Required Required ... Experience with Medicare Advantage populations * Experience with value-based care programs

Liberty Health

RISK ADJUSTMENT CODER

Wilmington, NC · On-site

$16 - $21.50/hr

RISK ADJUSTMENT CODER (MUST RESIDE IN NC) Job Summary: * Perform code abstraction of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation

GeBBS Healthcare Solutions

Risk Adjustment Coder

Coders will add risk-adjusting diagnoses that are valid but not reported Requirements Active certification through AAPC or AHIMA is required Minimum 5 years verifiable risk adjustment coding ...

Liberty Health

RISK ADJUSTMENT CODER

Wilmington, NC · Remote

$16 - $21.50/hr

RISK ADJUSTMENT CODER (MUST RESIDE IN NC) Job Summary: * Perform code abstraction of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation

Insight Global

Remote Medical Coder

Houston, TX · Remote

$18 - $22/hr

Medicare HCC experience is required * ICD 10 experience * 2 years' experience as a risk adjustment coder * CCS certified(AHIMA) or CPC certified (AAPC) * Provide own equipment * Pass a background ...

Insight Global

Hcc Coders

Charlotte, NC · Remote

$18 - $21/hr

Insight Global is seeking experienced HCC Risk Adjustment Medical Coders for a high-volume seasonal project supporting Medicare risk adjustment initiatives. Responsible for coding 2 Charts per hour.

Insight Global

Remote HCC Medical Coder

Houston, TX · Remote

$18 - $21/hr

Medicare HCC experience is required * ICD 10 experience * 2 years' experience as a risk adjustment coder * CCS certified(AHIMA) or CPC certified (AAPC) Plusses * Exposure to Medicaid HCC Coding ...

Alignment Health

The Assistant Vice President, Medicare Risk Adjustment Performance provides executive leadership ... Provides executive oversight for chart retrieval, coding production, provider engagement, and ...

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Medicare Risk Adjustment Coder information

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

As of Sep 13, 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 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 are the key skills and qualifications needed to thrive as a Medicare Risk Adjustment Coder?

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 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.

How much do Medicare Risk Adjustment Coders make in the US?

Medicare Risk Adjustment Coders in the US typically earn between $50,000 and $75,000 annually, depending on experience, certification, and location. Experienced coders with certifications like CPC or CRC may earn higher salaries, especially in healthcare hubs or with specialized skills in coding and compliance.

How to become a Medicare Risk Adjustment Coder?

To become a Medicare Risk Adjustment Coder, individuals typically need a coding certification such as Certified Professional Coder (CPC) or Certified Coding Specialist (CCS), along with knowledge of medical coding and billing, especially related to Medicare and risk adjustment models. Gaining experience in medical coding, understanding healthcare regulations, and staying current with coding updates are also important steps in pursuing this role.
More about Medicare Risk Adjustment Coder jobs

What are popular job titles related to Medicare Risk Adjustment Coder jobs?

For Medicare Risk Adjustment Coder jobs, the most frequently searched job titles are:

Medicare Risk Adjustment Coder jobs near you
Infographic showing various Medicare Risk Adjustment Coder job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 90% Full Time, 7% Part Time, and 2% Contract. Highlights an 82% Physical, 5% Hybrid, and 13% Remote job distribution, with an average salary of $46,638 per year, or $22.4 per hour.

HCC Risk Adjustment Coder

Franklin, TN • Remote

Vertek Staffing
Recruiting and Staffing Services • 11 - 50 employees
Learn more about Vertek Staffingexternal

$18 - $24/hr

Contractor

Re-posted 20 days ago

Job description

HCC / Risk Adjustment Coder - Remote

Risk Adjustment / HCC Coding Experience Required

Required Education
  • High School Diploma required with submission
Required Certifications

Online certification verification required with submission.

Candidates must possess one of the following certifications:

  • Certified Professional Coder (CPC) - AAPC
  • Certified Risk Adjustment Coder (CRC) - AAPC
  • Certified Coding Specialist (CCS) - AHIMA
  • Registered Health Information Technician (RHIT) - AHIMA
  • Registered Health Information Administrator (RHIA) - AHIMA

CRC Certification is highly preferred.

Schedule
  • Monday - Friday
  • Occasional weekend coverage may be required based on client needs
Position Summary

The HCC / Risk Adjustment Coder is responsible for reviewing medical records and clinical documentation to accurately identify, validate, and code chronic and acute conditions impacting patient risk scores and reimbursement.

The coder will ensure accurate assignment of ICD-10-CM diagnosis codes in accordance with CMS Risk Adjustment guidelines, Official ICD-10-CM Coding Guidelines, and client-specific requirements. This role supports Risk Adjustment initiatives through retrospective chart reviews, prospective reviews, coding validation, provider education support, and quality assurance activities.

The HCC Coder will collaborate with providers, CDI professionals, quality teams, population health departments, and coding leadership to ensure complete and accurate capture of chronic conditions and disease burden.

Key Responsibilities
  • Review medical records to identify and code HCC-eligible diagnoses.
  • Assign ICD-10-CM diagnosis codes in accordance with CMS and Risk Adjustment guidelines.
  • Validate chronic conditions and ensure documentation supports code assignment.
  • Perform retrospective and prospective chart reviews.
  • Identify missed HCC opportunities and documentation gaps.
  • Assist with coding validation and quality assurance audits.
  • Support provider education initiatives regarding Risk Adjustment documentation requirements.
  • Maintain productivity and quality standards established by the client.
  • Participate in internal and external audit activities.
  • Stay current on CMS Risk Adjustment regulations, coding updates, and industry best practices.
  • Assist leadership with special projects and additional duties as assigned.
Required Experience
  • Risk Adjustment / HCC coding experience required
  • Strong understanding of ICD-10-CM coding guidelines
  • Experience reviewing outpatient and provider documentation
  • Knowledge of CMS-HCC Risk Adjustment methodologies
  • Experience validating chronic conditions and disease burden
  • Strong attention to detail and coding accuracy
Preferred Experience
  • CRC certification
  • Experience with Medicare Advantage populations
  • Experience with value-based care programs
  • Experience performing coding audits and quality reviews
  • Experience with Epic, Cerner, Athena, eClinicalWorks, NextGen, or other EMR systems
  • Experience educating providers on Risk Adjustment documentation
 
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About Vertek Solutions

Sourced by ZipRecruiter

Vertek Solutions is a boutique staffing firm that specializes in recruiting top level IT talent who can enhance our clients’ teams. Our team works every day to foster relationships with both our consultants and clients to understand their needs and ensure that we are providing a solution that is mutually beneficial.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Franklin, TN, US

Year founded

2006

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