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Optum Health Coding Risk Adjustment Jobs in Dallas, TX

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82K - $108K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Datavant

Client Coding Project Manger (CCPM)

Dallas, TX · On-site

$7K/mo

... healthcare. What We're Looking For: The Client Coding Project Manager will provide superior quality by performing audits pertaining to risk adjustment coding efforts. They will be responsible for ...

Altegra Health

Remote Certified Coder

Dallas, TX · Remote

$22.25 - $30.50/hr

... Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from patient medical records. Assign ...

Altegra Health

Remote Certified Coder

Dallas, TX · On-site +1

$22.25 - $30.50/hr

... Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: • Abstract pertinent information from patient medical records. Assign appropriate ...

Pacer Group

Certified Coder (Varied) Dallas, TX

Dallas, TX · On-site

$22.25 - $30.50/hr

... Risk Adjustment Submission Requirements * AAPC certificate required; MUST be CPC, CPC-H and/or COC - REQUIRED * Must have graduated from an approved coding program or health information management ...

Oscar Health

Senior Actuarial Analyst

Dallas, TX · Remote

$91K - $120K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... This role will own the maintenance and review of actuarial models used to develop risk adjustment ...

Oscar Health

Senior Actuarial Analyst

Dallas, TX · Remote

$91K - $120K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... This role will own the maintenance and review of actuarial models used to develop risk adjustment ...

Oscar Health

Senior Actuarial Analyst

Dallas, TX · On-site

$91K - $120K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... This role will own the maintenance and review of actuarial models used to develop risk adjustment ...

Datavant

Payer Coding Ops Hourly

Dallas, TX · Remote

$25 - $26.70/hr

... risk adjustment and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of a patient's health ...

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Optum Health Coding Risk Adjustment information

See Dallas, TX salary details

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

As of Jun 13, 2026, the average hourly pay for optum health coding risk adjustment in Dallas, TX is $26.07, according to ZipRecruiter salary data. Most workers in this role earn between $21.39 and $29.23 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 Dallas, TX? The most popular types of Optum Health Coding Risk Adjustment jobs in Dallas, TX are:
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Optum Health Coding Risk Adjustment jobs near you
Infographic showing various Optum Health Coding Risk Adjustment job openings in Dallas, TX as of June 2026, with employment types broken down into 3% Internship, 68% Full Time, 17% Part Time, 3% Temporary, 8% Contract, and 1% Summer. Highlights an 78% Physical, 4% Hybrid, and 18% Remote job distribution, with an average salary of $54,229 per year, or $26.1 per hour.
Auditor, Risk Adjustment

Auditor, Risk Adjustment

Oscar Health

Dallas, TX • Remote

$82K - $108K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 15 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

228th of 261 rated insurance

Job description

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Associate, Risk Adjustment Auditor conducts internal and external quality audits. Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and identified clinical documentation improvement opportunities. You will work with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs.

You will report into the Manager, Risk Adjustment.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

  • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts.
  • Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation
  • Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented.
  • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards.
  • Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits.
  • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process.
  • Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business.
  • Manage the implementation process improvements that will maximize risk adjustment factor increases.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Bachelor's degree in a relevant field of study or commensurate work experience.
  • Certified professional coder (CPC)
  • 3+ year(s) retrospective risk adjustment coding experience.
  • 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV) experience

Bonus points:

  • Certified Risk Adjustment Coder (CRC) or similar certification
  • Experience coding in a variety of different Electronic Medical Record (EMR) systems.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

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