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Optum Health Coding Risk Adjustment Jobs (NOW HIRING)

Strive Health

Risk Adjustment Coder

Denver, CO · Remote

$27.88 - $32.21/hr

... coding and documentation to improve overall health outcomes for patients and continuity of care. This role will report to the Manager, Risk Adjustment. The Day to Day * Delivers value to Strive and ...

Strive Health

Risk Adjustment Coder

Denver, CO · On-site

$19.25 - $25.75/hr

... coding and documentation to improve overall health outcomes for patients and continuity of care. This role will report to the Manager, Risk Adjustment. The Day to Day * Delivers value to Strive and ...

Gather Health

Risk Adjustment Coding Specialist

Boston, MA · On-site

$65K - $85K/yr

Who is Gather Health? We are a new and growing healthcare organization with a unique and innovative ... The Risk Adjustment Coding Specialist will play a pivotal role in supporting accurate and complete ...

Gather Health

Risk Adjustment Coding Specialist

Boston, MA · On-site

$65K - $85K/yr

Description Who is Gather Health? We are a new and growing healthcare organization with a unique ... The Risk Adjustment Coding Specialist will play a pivotal role in supporting accurate and complete ...

Boston Medical Center

Risk Adjustment Coder

$19.25 - $25.50/hr

Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is required. Certification may include Certified Risk Adjustment ...

Gather Health

Risk Adjustment Coding Specialist

Boston, MA · On-site

$65K - $85K/yr

Who is Gather Health? We are a new and growing healthcare organization with a unique and innovative ... The Risk Adjustment Coding Specialist will play a pivotal role in supporting accurate and complete ...

Medasource

Risk Adjustment Coder

Manhattan, NY · On-site

$20.75 - $27.50/hr

This role is responsible for reviewing and validating diagnosis coding, ensuring documentation accuracy, and supporting audit readiness initiatives related to CMS HCC risk adjustment programs.

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How much do optum health coding risk adjustment jobs pay per hour?

As of Jun 3, 2026, the average hourly pay for optum health coding risk adjustment in the United States is $26.36, according to ZipRecruiter salary data. Most workers in this role earn between $21.63 and $29.57 per hour, depending on experience, location, and employer.

What is an Optum Health Coding Risk Adjustment job?

An Optum Health Coding Risk Adjustment job involves reviewing medical records to assign appropriate diagnosis codes that impact risk adjustment programs. These coders ensure accurate documentation of chronic conditions to support healthcare reimbursement models. They work with providers to improve coding accuracy and compliance with regulatory guidelines. Strong knowledge of ICD-10-CM coding, risk adjustment models, and healthcare regulations is essential.

What are the key skills and qualifications needed to thrive in the Optum Health Coding Risk Adjustment position, and why are they important?

To thrive as an Optum Health Coding Risk Adjustment professional, you need a strong understanding of ICD-10-CM coding, risk adjustment methodologies, and medical terminology, often supported by certifications like CPC, CRC, or CCS-P. Familiarity with electronic medical record (EMR) systems, coding software, and compliance tools is essential. Attention to detail, analytical thinking, and effective communication are valuable soft skills in this role. These competencies ensure accurate coding, regulatory compliance, and optimal risk adjustment, directly impacting healthcare quality and reimbursement.

What are the typical daily responsibilities of an Optum Health Coding Risk Adjustment specialist?

On a daily basis, Optum Health Coding Risk Adjustment specialists review medical records to identify and accurately code diagnoses, ensuring completeness and compliance with risk adjustment requirements. They collaborate closely with clinical teams and other coders to clarify documentation and resolve discrepancies. The role often involves conducting chart audits, submitting coding queries, and staying updated on the latest coding guidelines and regulatory changes. Attention to deadlines and maintaining data quality are key parts of the job, making it both detail-oriented and highly collaborative.
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Optum Health Coding Risk Adjustment jobs near you
Infographic showing various Optum Health Coding Risk Adjustment job openings in the United States as of May 2026, with employment types broken down into 93% Full Time, and 7% Contract. Highlights an 87% In-person, and 13% Remote job distribution, with an average salary of $54,819 per year, or $26.4 per hour.
HEALTH CODER - HCC & RISK ADJUSTMENT

HEALTH CODER - HCC & RISK ADJUSTMENT

NORTH EAST MEDICAL SERVICES

Burlingame, CA • Remote

$42.79 - $48.75/hr

Other

Posted 18 days ago

Job description

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization’s quality outcomes and financial performance.

ESSENTIAL JOB FUNCTIONS:

  • HCC Coding and Risk Adjustment (RA) Program Support
    • Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
    • Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
    • Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
  • Provider Training and Clinical Documentation Improvement (CDI)
  • Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
  • Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
  • Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
  • Data Analysis and Reporting
    • Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
    • Generate reports and dashboards to track coding performance and documentation accuracy.
    • Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
  • Compliance and Continuous Improvement
    • Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
    • Assist in the development and implementation of internal coding policies and procedures.
    • Participate in quality improvement initiatives related to coding and documentation.
    • Performs other job duties as required by manager/supervisor
  • Education & Certification:
    • BS/BA Degree in Health Science or General Education is required. 
    • Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
    • Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
  • Experience:
    • Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
    • Experience in provider education, clinical documentation improvement (CDI), and chart audits.
    • Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
  • Skills & Competencies:
    • Excellent communication, presentation, and interpersonal skills.
    • Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
    • Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
    • Proficiency in electronic health records (EHR) and coding software.
    • Strong analytical and problem-solving skills.

LANGUAGE:

  • Must be able to fluently speak, read and write English.
  • Fluency in other languages is an asset.

STATUS:

  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This a full-time position. 

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