ZipRecruiter

Log In

1

Medicare Risk Adjustment Jobs in Wisconsin (NOW HIRING)

previous page

Showing results 21-22

All JobsMedicare Risk Adjustment JobsMedicare Risk Adjustment Jobs in Wisconsin

Medicare Risk Adjustment information

See Wisconsin salary details

$12

$22

$40

How much do medicare risk adjustment jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for medicare risk adjustment in Wisconsin is $22.63, according to ZipRecruiter salary data. Most workers in this role earn between $16.25 and $27.40 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 Wisconsin?

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

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

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

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

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

Medicare Risk Adjustment jobs near you
Infographic showing various Medicare Risk Adjustment job openings in Wisconsin as of August 2026, with employment types broken down into 1% As Needed, 88% Full Time, 8% Part Time, and 3% Contract. Highlights an 87% Physical, 5% Hybrid, and 8% Remote job distribution, with an average salary of $47,069 per year, or $22.6 per hour.

Medical Coding Specialist II - Profee Radiology

UW Health

Middleton, WI • On-site

Other

Medical, Dental, Retirement, PTO

This job post has expired 1 day ago. Applications are no longer accepted.

UW Health rating

7.9

Company rating: 7.9 out of 10

Based on 224 frontline employees who took The Breakroom Quiz

107th of 888 rated healthcare providers

Job description

Work Schedule:
This is a full-time, 1.0 FTE position that is 100% remote. This will have flexible shifts scheduled Monday - Friday and will be discussed in the interview. Hours may vary based on the operational needs of the department. Applicants hired into this position can work from most states. This will be discussed during the interview process.

To be eligible to work remotely, you must be in an approved remote work state for UW Health. We've included a link below to view the full list of approved remote work states.

Approved Remote Work States Listing

Be part of something remarkable


Join the #1 hospital in Wisconsin!

We are seeking a Medical Coding Specialist II to:

  • Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes.
  • Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents and National Coverage Documents (LCD/NCD) directives, Medically Unlikely Edits (MUEs), and Medicare Teaching Physician Guidelines, applying knowledge of applicable regulatory requirements and institutional guidelines to select appropriate codes and modifiers.

At UW Health, you will have:

  • An excellent benefits package, including health and dental insurance, paid time off, retirement plans, two-week paid parental leave and adoption assistance.
  • Options for a variety of schedules and shifts that offer flexibility and allow for work-life balance.
  • Access to great resources through the UW Health Employee Wellbeing Department that supports your emotional, financial, and physical well-being.
  • Tuition benefits eligibility - UW Health invests in your professional growth by helping pay for coursework associated with career advancement.

Qualifications

  • Medical coding education Required or In lieu of a medical coding education, an active coding certification Required
  • High School Diploma or equivalent Preferred
  • Associate's Degree in a healthcare related field Preferred

Work Experience

  • 1 year of progressive coding experience (For HCC-specific roles, experience must be specific to HCC) Required
  • 2 years progressive coding experience in multiple specialties, HCC Risk adjustment Coding Preferred

Licenses & Certifications

  • Certified Professional Coder (CPC) Upon Hire Required or
  • Certified Outpatient Coder (COC) Upon Hire Required or
  • Certified Inpatient Coder (CIC) Upon Hire Required or
  • Certified Coding Specialist (CCS) Upon Hire Required or
  • Certified Coding Specialist Physician-Based (CCS-P) Upon Hire Required or
  • Certified Coding Associate (CCA) Upon Hire Required or
  • Certified Risk Adjustment Coder (CRC) Upon Hire Required or
  • Registered Health Information Technician (RHIT) Upon Hire Required or
  • Registered Health Information Administrator (RHIA) Upon Hire Required
  • Registered Health Information Technician (RHIT) Preferred or
  • Registered Health Information Administrator (RHIA) Preferred

Our Commitment to Social Impact and Belonging

UW Health is committed to fostering a workplace that creates belonging for everyone and is an Equal Employment Opportunity (EEO) employer. Our respect for people shines through patient care interactions and our daily work practices as we work to embrace the knowledge, unique perspectives and qualities each employee and faculty member brings to work each day. It is the policy of UW Health to provide equal opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Job Description

UW Medical Foundation Benefits

What UW Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

UW Health logo

About UW Health

Sourced by ZipRecruiter

UW Health Clinics - our physicians and staff are dedicated to providing an exceptional patient and family experience by delivering the highest quality of care in a compassionate environment. With more than 80 primary and specialty care clinics located throughout Dane County and the surrounding areas, we are proud to have the opportunity to impact the communities we serve.

Industry

Health care and social assistance and hospitals

Company size

10,000+ Employees

Headquarters location

Madison, WI, US

View All UW Health Jobs

Apply