ZipRecruiter

Log In

1

Medicare Risk Adjustment Coder Jobs (NOW HIRING)

Vytwo

Risk Adjustment Coding Auditor

Prosper, TX · On-site

$25 - $28.50/hr

This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required skillset: MS Suite CPC certified CRC certified 5+ years of risk ...

New

Mercor

HCC Coding Leader - Risk Adjustment

New York, NY · Remote

$110/hr

CRC (Certified Risk Coder) , CCS , CPC , or RHIA credential. * Experience with risk adjustment analytics platforms and chart retrieval systems. * Background in health plan, Medicare Advantage ...

Medix

Risk Adjustment Director

Scotts Valley, CA · On-site

$96.15 - $120.19/hr

Expert knowledge of Medicare HCC risk adjustment models. * Working knowledge of CPT, HCPCS, and ICD-9/10 medical coding. * Familiarity with data analytical tools like SQL and visualization platforms ...

next page

Showing results 1-20

All JobsMedicare Risk Adjustment Coder Jobs

Medicare Risk Adjustment Coder information

See salary details

$15

$22

$34

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

As of Jul 12, 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 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.

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 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 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.
More about Medicare Risk Adjustment Coder jobs
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 July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, and 7% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $46,638 per year, or $22.4 per hour.

Certified Medical Coder - Risk Adjustment

Porter Cares, Inc.

Pompano Beach, FL • On-site

$50K - $54K/yr

Full-time

Posted 18 days ago

Job description

Porter is hiring a Risk Adjustment Coder to join our Team!
Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.
Position Overview
We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health assessments. The ideal candidate will have a strong understanding of CMS risk adjustment and quality initiatives, exceptional attention to coding quality, and experience managing the provider query process. This role also requires the ability to handle multiple clients, each with unique coding requirements, while ensuring accuracy and compliance. Proficiency in utilizing coding clinics for provider education and feedback is essential. This role will be instrumental in ensuring the accuracy of coding and improving the efficiency of our assessment workflows. A key expectation is that the Risk Adjustment Coder will maintain 98% coding accuracy.
Schedule: Monday - Friday (some weekends and overtime)
Start: 8am-8:30am ET
Hybrid: Pompano Beach, FL
*This is not a lead or manager position
Key Responsibilities
• Assign accurate ICD-10, CPT, and CPT II codes based on documentation from in-home assessments, ensuring compliance with CMS risk adjustment and quality guidelines.
• Manage the provider query process to clarify documentation and ensure the completeness and accuracy of patient diagnoses, particularly related to chronic conditions.
• Handle multiple clients with varying coding requirements, maintaining high standards of accuracy and adapting to specific client guidelines.
• Utilize coding clinics and other reference materials to provide providers with targeted feedback and education on improving documentation and coding accuracy.
• Maintain a minimum of 98% coding accuracy to meet performance expectations and ensure compliance.
• Stay current with coding standards, risk adjustment methodologies, and CMS regulatory changes to ensure ongoing compliance and optimal coding practices.
• Collaborate with clinical teams to review documentation and provide insights on areas for improvement in coding and documentation.
• Support coding education initiatives by creating and delivering training materials to providers, particularly focused on improving documentation practices.
• Maintain confidentiality and ensure full compliance with HIPAA regulations.
$50,000 - $54,000 a year
This is not a leadership or senior position.
Qualifications
- Certification Required - CPC or CSS
- Minimum 5 years of experience in risk adjustment coding, with specific experience in in-home assessments.
- Expertise in managing provider queries and improving provider documentation through coding feedback.
- Proficiency in using coding clinics and reference tools for accurate coding and provider education.
- Strong knowledge of CMS risk adjustment and quality initiatives, including Hierarchical Condition Categories (HCCs).
- Experience with electronic medical records (EMR) and coding tools.
- Excellent communication skills, with the ability to collaborate with providers and clinical teams to drive coding improvements.
- Strong attention to detail, prioritizing coding quality and compliance.
Preferred Qualifications
Experience in coding audits and providing actionable feedback to providers.
Knowledge of healthcare reimbursement models and regulations impacting risk adjustment coding.
Prior experience in telehealth or in-home care settings.
Benefits
Competitive wage and benefits package.
Opportunities for professional growth and continuing education.
A supportive, collaborative work environment.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Apply