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Optum Health Coding Risk Adjustment Jobs in North Carolina

Wilmington Health PLLC

Actuary

Wilmington, NC · On-site

Wilmington Health is structured as a multi-specialty medical practice with primary care providers ... Analyze risk adjustment data, including HCC/RAF trends, coding patterns, demographic factors ...

RVO Health

Senior Software Engineer, Golang

Charlotte, NC · On-site

$118K - $150K/yr

Experience using AI for code generation. Preferred: * Previous experience with healthcare ... Optum Perks, and the virtual coaching platforms Real Appeal, Wellness Coaching, and QuitForLife. We ...

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Optum Health Coding Risk Adjustment information

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$13

$23

$34

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

As of Jul 30, 2026, the average hourly pay for optum health coding risk adjustment in North Carolina is $23.95, according to ZipRecruiter salary data. Most workers in this role earn between $19.66 and $26.88 per hour, depending on experience, location, and employer.

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.

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 most commonly searched types of Optum Health Coding Risk Adjustment jobs in North Carolina? The most popular types of Optum Health Coding Risk Adjustment jobs in North Carolina are:
What are popular job titles related to Optum Health Coding Risk Adjustment jobs in North Carolina? For Optum Health Coding Risk Adjustment jobs in North Carolina, the most frequently searched job titles are:
What job categories do people searching Optum Health Coding Risk Adjustment jobs in North Carolina look for? The top searched job categories for Optum Health Coding Risk Adjustment jobs in North Carolina are:
Optum Health Coding Risk Adjustment jobs near you
Infographic showing various Optum Health Coding Risk Adjustment job openings in North Carolina as of July 2026, with employment types broken down into 87% Full Time, and 13% Contract. Highlights an 57% In-person, and 43% Remote job distribution, with an average salary of $49,819 per year, or $24 per hour.

Risk Adjustment Coding Specialist II

Millennium Physician Group

Concord, NC

$22 - $33/hr

Full-time

Posted 5 days ago

Millennium Physician Group rating

6.3

Company rating: 6.3 out of 10

Based on 62 frontline employees who took The Breakroom Quiz

672nd of 890 rated healthcare providers

Job description

Job Description Summary

Under the direction of Burden of Illness department leadership, the Risk Adjustment Coding Specialist is responsible for various aspects of decision-making and coding reviews to facilitate, obtain, validate, and reconcile appropriate provider documentation for clinical conditions that accurately reflect the severity of illness and complexity of patient care.

How will you make an impact & Requirements

Responsibilities

  • Perform prospective medical record reviews forclinical indicators supportive of an underlying diagnosis to be presented to a clinician for review during a subsequent face-to-face encounter.
  • Review the encounter level patient medical record and provider selected ICD-10-CM diagnosis codes in real time prior to claim submission to validate completeness and accuracy of provider selected ICD-10-CM codes.
  • Collaborate with healthcare providers and other stakeholders to clarify documentation and ensure accurate coding and reporting of diagnoses.
  • Stay updated on changes to Medicare guidelines, coding regulations, and reimbursement methodologies to ensure compliance and accuracy in coding practices.
  • Participate in coding education and training initiatives for staff to promote consistent and accurate coding practices across the organization.
  • Stays current on applicable coding and documentation guideline changes and rules.
  • This role is expected to maintain a consistent accuracy rate of 95% or higher and able to meet productivity standards established by leadership.
  • Abstract and assign ICD-10-CM diagnosis codes supported in the encounter documentation not initially assigned to the encounter claim following ICD-10-CM Official Guidelines for Coding and Reporting.
  • Conduct retrospective audits of medical recordsto validate the accuracy and completeness of diagnosis coding and claim submission, identifying and resolving any discrepancies or areas for improvement.
  • Perform comprehensive reviews of provider actions within the Value Based Alert Tool (VBAT) to identify outliers and areas of opportunity.
  • Analyze MRA data to identify patterns andwhen requestedassist in the development of interventions at the provider andregionlevel.
  • Keeps department leadership appraised of project activities through regular written and oral status reports. Proactively identifies risks that may hinder project success.

Compensation:

$22.00

to

$33.00

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