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Medicare Risk Adjustment Provider Educator Jobs

Village Care

Risk Adjustment Coding Manager

Manhattan, NY · On-site

$102K - $115K/yr

Medicare Risk Adjustment Coding Manager Location: Remote (Must Reside in NY/NJ/CT) Work Schedule ... By eliminating redundant provider outreach and maximizing the clinical value of each chart ...

Village Care

Risk Adjustment Coding Manager

Manhattan, NY · On-site

$102K - $115K/yr

Medicare Risk Adjustment Coding Manager Location: Remote (Must Reside in NY/NJ/CT) Work Schedule ... By eliminating redundant provider outreach and maximizing the clinical value of each chart ...

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Medicare Risk Adjustment Provider Educator information

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$43

$68

How much do medicare risk adjustment provider educator jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for medicare risk adjustment provider educator in the United States is $43.95, according to ZipRecruiter salary data. Most workers in this role earn between $33.65 and $52.40 per hour, depending on experience, location, and employer.

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

To thrive as a Medicare Risk Adjustment Provider Educator, you need in-depth knowledge of risk adjustment coding, Medicare guidelines, and clinical documentation, usually supported by a relevant healthcare degree and certifications like CPC, CRC, or CCS-P. Familiarity with coding software, EMR systems, and data analytics tools is essential for analyzing records and providing effective education. Strong communication, presentation, and relationship-building skills distinguish top performers in this role. These abilities ensure accurate coding, regulatory compliance, and improved provider understanding, which are critical for optimizing reimbursement and reducing audit risk.

What are Medicare Risk Adjustment Provider Educators?

Medicare Risk Adjustment Provider Educators are professionals who train healthcare providers on accurately documenting and coding patient diagnoses for Medicare risk adjustment purposes. Their main goal is to ensure that providers understand the importance of thorough and precise medical record documentation, which directly impacts Medicare payments and compliance. They often lead educational sessions, review documentation practices, and provide ongoing support to help providers meet regulatory standards. By doing so, they help healthcare organizations receive appropriate reimbursement and improve patient care quality.

How does a Medicare Risk Adjustment Provider Educator typically collaborate with healthcare providers and coding teams?

A Medicare Risk Adjustment Provider Educator works closely with healthcare providers and coding teams to ensure accurate documentation and coding of diagnoses for risk adjustment purposes. They often conduct training sessions, provide feedback on documentation practices, and clarify coding guidelines to both individual clinicians and group practices. Regular collaboration may involve joint chart reviews, educational workshops, and ongoing communication to address documentation gaps or regulatory updates. This role requires strong interpersonal skills and an ability to translate complex regulatory information into practical guidance for busy clinical teams.

What is the difference between Medicare Risk Adjustment Provider Educator vs Medicare Risk Adjustment Analyst?

AspectMedicare Risk Adjustment Provider EducatorMedicare Risk Adjustment Analyst
CredentialsTypically requires healthcare certifications, training in risk adjustment, and teaching experienceRequires healthcare or data analysis certifications, proficiency in data tools, and risk modeling knowledge
Work EnvironmentEducational settings, provider offices, or training programsData analysis departments, healthcare organizations, or insurance companies
Employer & Industry UsageHospitals, health plans, and training organizationsInsurance companies, healthcare analytics firms, and health plans

The Medicare Risk Adjustment Provider Educator focuses on training healthcare providers on risk adjustment processes, while the Medicare Risk Adjustment Analyst analyzes data to optimize risk scores. Both roles require healthcare knowledge but differ in their primary functions and work environments.

Infographic showing various Medicare Risk Adjustment Provider Educator job openings in the United States as of May 2026, with employment types broken down into 4% As Needed, 70% Full Time, 19% Part Time, 6% Contract, and 1% Nights. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $91,418 per year, or $44 per hour.
Medicare Risk Adjustment Specialist - Medical Assistant

Medicare Risk Adjustment Specialist - Medical Assistant

Complete Health

Jacksonville, FL • On-site

$16.50 - $20.75/hr

Full-time

Posted 14 days ago

Complete Health rating

6.8

Company rating: 6.8 out of 10

Based on 21 frontline employees who took The Breakroom Quiz

Job description

SUMMARY OF JOB DUTIES:
Searching for a strong Medical Assistant or Certified Nursing Assistant for a rapidly growing company who would like to come off the floor and become a Medicare Risk Adjustment Specialist.
ESSENTIAL JOB FUNCTIONS:
  • Reviews medical record and claims information to identify all appropriate coding based on Centers for Medicare and Medicaid Services Hierarchical Condition Categories (CMS-HCC & HHS-HCC) models
  • Abstract all risk adjusted diagnosis codes from acceptable provider documentation and in accordance with industry standards for coding and reporting.
  • Adherence to current industry standard, as defined in the ICD-10 guidelines for coding and reporting.
  • Conduct Provider queries for any documentation for risk conditions within client electronic medical record and/or other query system
  • Develop and share guidelines/best practices with internal risk adjustment coders to improve coding documentation techniques.
  • Help with special projects within our Risk Adjustment Department

KNOWLEDGE/SKILLS/ABILITIES:
  • Critical Thinking
  • Excellent time management skills and ability to multi-task and prioritize work
  • Strong organizational and planning skills
  • Flexibility
  • Team Player
  • Autonomy

MINIMUM REQUIREMENTS
  • High School Diploma or Equivalent (Required)
  • Medical Assistant or Certified Nursing Assistant
  • 2 -- 3 years Back Office, Primary Care preferred

WORKING ENVIRONMENT
The position requires climbing, stooping, kneeling, crouching, reaching, standing, lifting, grasping, feeling, talking, hearing, repetitive motions, and finger use. Pushing and pulling are occasionally required. Use of a computer, keyboard, and telephone along with various office machines is an essential part of the job.
DISCLAIMER
The above statements are intended to describe the general nature and level of work being performed by the Medicare Risk Adjustment Coder. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The Medicare Risk Adjustment Coder may be required to perform duties outside of their normal responsibilities from time to time as needed or as directed by supervision.

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