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How much do medicare risk assessment jobs pay per hour?

As of Jun 30, 2026, the average hourly pay for medicare risk assessment in the United States is $38.68, according to ZipRecruiter salary data. Most workers in this role earn between $23.80 and $54.33 per hour, depending on experience, location, and employer.

What is a Medicare Risk Assessment job?

A Medicare Risk Assessment job involves evaluating patients' health conditions to determine risk scores that impact Medicare Advantage plan reimbursements. Professionals in this role collect and analyze medical data, review patient histories, and ensure accurate coding of diagnoses. Their work helps healthcare providers and insurers understand patient risks and deliver appropriate care. Strong knowledge of ICD-10 coding, healthcare regulations, and medical terminology is essential for this role.

What are some common challenges faced in a Medicare Risk Assessment role?

One common challenge in Medicare Risk Assessment is staying up to date with frequently changing Medicare regulations and coding requirements, which directly affect risk scoring and patient documentation. Handling large volumes of patient data while ensuring accuracy and compliance can also be demanding, as errors may impact reimbursement and care outcomes. Collaboration with clinicians, billing teams, and administrators is often necessary to clarify complex cases and ensure complete, compliant documentation. Successfully navigating these challenges requires ongoing learning, keen attention to detail, and effective communication skills.

What are the key skills and qualifications needed to thrive in the Medicare Risk Assessment position, and why are they important?

To thrive in a Medicare Risk Assessment role, you need a strong understanding of healthcare regulations, Medicare guidelines, data analysis, and clinical assessment—often supported by a background in nursing, healthcare administration, or a related field. Proficiency with health risk assessment tools, electronic health records (EHRs), and data management systems is important, and certification such as Certified Risk Adjustment Coder (CRC) can be beneficial. Attention to detail, analytical thinking, and effective communication stand out as key soft skills in this position. These skills are crucial for accurately evaluating patient risk, ensuring compliance, and supporting optimal Medicare plan outcomes.

More about Medicare Risk Assessment jobs
What cities are hiring for Medicare Risk Assessment jobs? Cities with the most Medicare Risk Assessment job openings:
What states have the most Medicare Risk Assessment jobs? States with the most job openings for Medicare Risk Assessment jobs include:
What job categories do people searching Medicare Risk Assessment jobs look for? The top searched job categories for Medicare Risk Assessment jobs are:
Medicare Risk Assessment jobs near you
Infographic showing various Medicare Risk Assessment job openings in the United States as of June 2026, with employment types broken down into 1% Internship, 4% As Needed, 41% Full Time, 44% Part Time, and 10% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $80,460 per year, or $38.7 per hour.
Medicare Risk Adjustment Specialist I

Medicare Risk Adjustment Specialist I

On Belay Health Solutions

Remote

$25 - $28/hr

Full-time

PTO

Posted 7 days ago

Key responsibilities

  • Review and validate AI-identified risk adjustment coding opportunities within medical records.

  • Assess clinical documentation to determine the appropriateness of proposed diagnoses and HCC submissions.

  • Support the quality assurance process for AI-assisted chart reviews by identifying coding discrepancies, false positives, and missed opportunities.

Job description

About On Belay Health Solutions
On Belay Health Solutions is a Massachusetts-based physician-led managed services organization (MSO) devoted to supporting independent primary care physicians. On Belay provides enhanced Medicare value-based contracts that empower physicians with the resources necessary to invest in innovative care models and population health management tools. This allows physicians to practice medicine and positively impact the health of their communities in the way they have always dreamed.
About the role
We are seeking a detail-oriented Medicare Risk Adjustment Coding Specialist to support our innovative AI-driven chart review and risk adjustment programs. This role differs from a traditional retrospective chart review position. Rather than conducting full manual chart reviews, the specialist will work alongside advanced AI technology to validate, refine, and support coding opportunities identified through automated chart analysis.
The ideal candidate will possess strong knowledge of Medicare Advantage risk adjustment methodologies, HCC coding, and clinical documentation requirements, while demonstrating the ability to evaluate AI-generated coding recommendations and ensure accuracy, compliance, and coding integrity.
This is a Full-Time role with expectation for 40 hours per week. We look forward to meeting interested applicants and mutually assessing fit in joining On Belay on our important mission to transform healthcare!
What you'll do
  • Review and validate AI-identified risk adjustment coding opportunities within medical records.
  • Assess clinical documentation to determine the appropriateness of proposed diagnoses and HCC submissions.
  • Support the quality assurance process for AI-assisted chart reviews by identifying coding discrepancies, false positives, and missed opportunities.
  • Develop feedback loop with On Belay's Head of Risk Adjustment Coding and physician offices On Belay supports, including but not limited to:
    • Identification of quality improvement opportunities in individual physician coding
  • Any other related duties assigned at manager's discretion

Qualifications
  • High school diploma or GED required. Associates degree preferred.
  • Active coding certificate required. AAPC or AHIMA coding certification preferred.
    • Required: CCS-P (Certified Coding Specialist- Physicianbased) or CPC (Certified Professional Coder)
    • Preferred: CRC (Certified Risk Adjustment Coder)
  • Experience in a primary care setting highly preferred.
  • Knowledge of medical terminology and medical chart review required. Two (2) or more years' experience of hierarchical condition categories (HCC)
  • Knowledge of ICD-10-CM Official Guidelines for Coding and Reporting
  • Knowledge of AHA Coding Clinic and authoritative coding resources
  • Knowledge of Microsoft Office suite, primarily Excel (specifically Pivot Tables, sort and filter functions)
  • Strong time management skills required
  • Ability to navigate within various EMRs (Electronic Medical Records), Cerner Preferred
  • Strong interpersonal, communication (verbal, non-verbal and listening) skills
  • Ability to remain productive under time constraints and meet deadlines critical to the business

Benefits
  • Innovative, revolutionary environment
  • Great culture with a strong sense of mission and community
  • Eleven (11) Paid Holidays
  • Lavish PTO accrual
  • Advancement opportunities & professional skills training
  • Strong referral bonus program
  • And more!

Compensation
  • We offer a competitive base salary ranging from $25 - $28 per hour.

Come join us on the journey to better and more affordable healthcare!
We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.

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