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Medicare Risk Adjustment Jobs in Ohio (NOW HIRING)

Kettering Home Care

Physical Therapist Weekend

Kettering, OH · On-site

$1.4K - $1.9K/wk

Patient Risk : Helps decrease re-hospitalizations by front loading visits for high-risk patients ... Completes all clinical documentation following agency protocol and Medicare/Federal guidelines.

Kettering Home Care

Physical Therapist Weekend

Kettering, OH · On-site

$1.4K - $1.9K/wk

Patient Risk : Helps decrease re-hospitalizations by front loading visits for high-risk patients ... Completes all clinical documentation following agency protocol and Medicare/Federal guidelines.

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How much do medicare risk adjustment jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for medicare risk adjustment in Ohio is $21.31, according to ZipRecruiter salary data. Most workers in this role earn between $15.29 and $25.82 per hour, depending on experience, location, and employer.

What is Medicare Risk Adjustment?

Medicare Risk Adjustment is a process used by the Centers for Medicare & Medicaid Services (CMS) to adjust payments to Medicare Advantage plans based on the health status and demographic characteristics of their enrolled beneficiaries. The goal is to ensure that plans receive appropriate compensation for taking care of members with varying levels of health risk. This system uses diagnosis codes and other data to predict future healthcare costs, encouraging plans to provide comprehensive care and accurately document patient conditions.

What are jobs in Medicare Risk Adjustment?

Jobs in Medicare risk adjustment include work in data analytics, consulting, insurance, and closely related industries. Your duties and responsibilities differ depending on the type of work. For example, as a Medicare risk-adjustment consultant, you provide advice and recommendations to healthcare organizations or an insurance provider on how to mitigate risk across a customer pool. Data analytics and statistics specialists gather and analyze insurance and Medicare data and documentation from hospitals, healthcare providers, and other medical care facilities that accept Medicare. This includes reviewing different types of diagnosis and comparing patient chart information. Some health care providers have in-house risk adjustment workers, while others contract with outside consulting and analytics firms.

What are the key skills and qualifications needed to thrive in Medicare Risk Adjustment?

To excel in Medicare Risk Adjustment, you need a solid understanding of medical coding (especially ICD-10), healthcare regulations, and risk adjustment methodologies, often supported by credentials like CRC or CPC certifications. Familiarity with data analytics platforms, EHR systems, and specialized risk adjustment software is typically required. Strong attention to detail, analytical thinking, and effective communication are crucial soft skills for interpreting complex clinical data and collaborating across teams. These competencies ensure accurate risk scores, compliance with CMS requirements, and optimal financial outcomes for healthcare organizations.

What are some common challenges faced by professionals working in Medicare Risk Adjustment roles?

Professionals in Medicare Risk Adjustment often encounter challenges such as staying current with frequently changing CMS regulations, ensuring the accurate capture and documentation of patient diagnoses, and collaborating effectively with providers to optimize risk scores. The role requires meticulous attention to detail when reviewing medical records and coding, as well as strong communication skills to educate and support healthcare teams. Additionally, there can be pressure to meet strict deadlines for data submission and to ensure compliance with audit standards.

What is the difference between Medicare Risk Adjustment vs Medicare Coding Specialist?

AspectMedicare Risk AdjustmentMedicare Coding Specialist
Primary FocusAssessing patient health risk scores for reimbursementAccurately coding medical diagnoses and procedures
Required CredentialsCertifications in risk adjustment or coding, often CPC or RHITCertifications like CPC, CCS, or RHIT
Work EnvironmentHealth plans, risk adjustment companies, healthcare providersHospitals, clinics, billing departments
Industry UsageUsed for Medicare Advantage plan reimbursementsUsed for medical billing and claims processing

While both roles involve healthcare coding and require similar certifications, Medicare Risk Adjustment focuses on evaluating patient health data to determine reimbursement levels, whereas Medicare Coding Specialists concentrate on accurately coding diagnoses and procedures for billing purposes.

More about Medicare Risk Adjustment jobs

What are the most commonly searched types of Medicare Risk Adjustment jobs in Ohio?

The most popular types of Medicare Risk Adjustment jobs in Ohio are:

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

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

What job categories do people searching Medicare Risk Adjustment jobs in Ohio look for?

The top searched job categories for Medicare Risk Adjustment jobs in Ohio are:

Medicare Risk Adjustment jobs near you
Infographic showing various Medicare Risk Adjustment job openings in Ohio as of August 2026, with employment types broken down into 1% As Needed, 91% Full Time, 6% Part Time, and 2% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $44,333 per year, or $21.3 per hour.

Physical Therapist PRN

Summa Health at Home and Hospice

Akron, OH • On-site

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 23 days ago

Job description

Agency:
Summa Health at Home and Hospice
Our culture and people are what set us apart from other post-acute care providers. We're dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY.
Note: The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), require COVID-19 vaccinations for all Medicare and Medicaid certified providers. Based on this regulation, all of our employees must be fully vaccinated or have a valid exemption.
As needed. mon-friday. 5 points a week
HOW YOU'LL MAKE A DIFFERENCE:
Care and compassion are at the heart of what you'll do as a Physical Therapist (PT). You'll be part of an interdisciplinary team that focuses on providing compassionate quality care and producing positive outcomes for your patient population. You'll provide home-based therapy care for patients as directed by the attending physician. Interacting with patients' families while caring for your patients and experiencing the rewarding privilege to be part of every step of their recovery journey. Home care provides context and real-world perspective about what will really help patients restore their health.
WHAT WE OFFER:
We make it easy to do your job and have competitive financial incentives. On a pay per visit model, the more visits you make, the more you will earn! We pay mileage and have bonus opportunities. Our schedules are flexible, and you'll have the support of a whole team, from scheduling to patient admissions. Our benefits package is also competitive in the market. We provide medical, dental, and vision insurance with flexibility for you to select what works best for you. Eligible teammates will also receive paid time off, opportunity to participate in 401k, company paid life insurance and access to a robust Employee Assistance Program.
HOW YOU'LL WORK:
You'll provide comprehensive skilled services as ordered by the attending physician. You will educate patients and their family members and ensures the safety of the patient. You are accountable for completing accurate documentation and remaining compliant with all legal rules and regulations.
QUALIFICATIONS & ATTRIBUTES:
  • Physical Therapist with a current license in the state of employment.
  • Minimum of one year of experience as an PT in an acute setting is required.
  • Home care experience is desired.
  • Ability to effectively communicate and create positive impressions with patients, families, physicians and co-workers.
  • Knowledgeable on therapy best practices.
  • Ability to make appropriate physical therapy judgments.
  • Ability to identify a situation and handle it with the best possible solution.
  • Detail-oriented and observant.
  • Disciplined style of work ethic with the ability to prioritize and be timely.
  • Valid driver's license and auto insurance with your name as a listed driver.

MAJOR AREAS OF RESPONSIBILITY:
  • Provides skilled physical therapy in a patient's home as ordered by the attending physician
  • Observes, records, and reports patient reactions, changes, and progress to attending physician and any appropriate agency staff
  • Performs OASIS assessments to develop an individualized plan of care and makes adjustments as needs change
  • Completes initial evaluation and admission visit within 48-72 hours of referral
  • Develops plan of care
  • Helps decrease re-hospitalizations by front loading visits for high risk patients
  • Treats patients to relieve pain, develop or restore function, and maintain maximum performance using physical means, such as, exercise, massage, heat, water, etc.
  • Arranges the provision of services listed above on an outpatient basis which cannot be given in the patient's home
  • Promotes continuity of care with appropriate admissions, transfers and discharges
  • Counsels patient and family on the disease/injury and how to manage in all phases of physical therapy
  • Incorporates patient and family in development of plan of care
  • Instructs patient and family members on proper use of equipment such as wheelchairs, braces, walkers, crutches, canes, and other prosthetic/orthotic devices
  • Ensures patient/family know financial responsibility for needed equipment by utilizing DME department and/or MSW
  • Helps decrease re-hospitalizations by teaching the patient on preventative measures and making good decisions
  • Listens to patient and family members
  • Oversees and supervises therapy services of patient provided by PTAs and when appropriate, nurse assistants
  • Evaluates the POC based on patient response to treatment/medical condition and adjusts as needed.
  • Communicates with the PTAs and nurse aides on supervisory visit results
  • Completes all clinical documentation in accordance with agency protocol and Medicare/Federal guidelines
  • Documents all aspects of treatment, assessments, and patient education
  • Completes chart audits at agency site location as requested
  • Maintains active PT license in state of employment
  • Communicates with scheduler any changes as needed
  • Participates in all on-call requirements and case conferences
  • Attends in-service trainings and mandatory agency meetings
  • Participates in orientation/training of new employees
  • Maintains a professional appearance as a representative of the company
  • Understands and practices agency policies and procedures

ESSENTIAL FUNCTIONS:
  • Drives to patient's primary location per scheduled visit.
  • Daily attendance at assigned visit locations.
  • Documents all aspects of subsequent, discharge, eval/recert/resumption of care visits within 24 hours of visits. Documents all aspects of start of care visits within 48 hours of visits.
  • Completes and submits all required documentation within specified company requirements.
  • Establishes and follows plan of care as permitted within the scope of practice for a Licensed Physical Therapy, per the state of employment.

HEALTH QUALIFICATIONS:
Health Requirements: Must be able to meet all physical position requirements. Evidence required of a current negative tuberculin skin test or x-ray or receive TB testing at the date of orientation. Thereafter an annual tuberculin skin test is required, unless the employee has documentation of a previous TB test. Employee must be free of physical/medical conditions, which would limit or restrict their ability to perform the job functions listed below. Employees in this position may be at risk for exposure to bloodborne pathogens.
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Below are minimal knowledge/physical requirements of this position. Travel is required for this position.
Constantly (66%-100%):
Reading, Speaking, Writing English
Communications Skills
Computer/PDA Usage
Hearing/Seeing
Talking in person
Hearing in person
Vision for close work
Talking on the phone
Hearing on the phone
Stretching/Reaching
Walking
Sitting
Bending
Standing
Frequently (34%-66%)
Driving
Lifting up to 50 lbs. with or without assistance
Climbing
Stooping (bend at waist)
Hand/finger dexterity
Occasionally (2%-33%)
Distinguish smell/taste
Rarely (1% or less)
N/A
We'll help you put your passion for patient care to work. Apply today!
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.
We are an Equal Opportunity Employer.

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