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Optum Health Coding Risk Adjustment Jobs in Dallas, TX

Palm Medical Centers

Primary Care Physician

Mansfield, TX · On-site

$250K - $300K/yr

... coding for risk adjustment * Participate in multidisciplinary meetings and quality improvement ... Health insurance * Life insurance * Paid time off * Relocation assistance * Retirement plan

Palm Medical Centers

Primary Care Physician

Dallas, TX · On-site

$250K - $300K/yr

... coding for risk adjustment * Participate in multidisciplinary meetings and quality improvement ... Health insurance * Life insurance * Paid time off * Relocation assistance * Retirement plan

JPS Health Network

EXEC DIR HIM

Fort Worth, TX · On-site

Supports accurate reporting of CMI, SOI/ROM, risk adjustment, quality metrics, and value-based care ... coding. Preferred Qualifications: * Master's degree in Health Information Management, Health ...

SmartIPlace

REQ :: Actuary

Dallas, TX · Remote

$60 - $65/hr

We would like to conduct a TRA to quantify risk across various risk sources (Insurance risk, Healthcare cost trend risk, risk adjustment risk, Member risk/selection risk) at the market segment level.

2844

Coding Specialist III

Dallas, TX · Remote

Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare ... Supports audit and denial escalation review and evaluates and resolves high-risk AI-assisted coding ...

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Optum Health Coding Risk Adjustment information

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$26

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

As of Jun 14, 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.
Healthcare Statistical Data Scientist

Healthcare Statistical Data Scientist

SmartLight Analytics

Plano, TX • On-site, Remote

Full-time

Posted yesterday

Job description

Overview
We're seeking a Machine Learning Data Scientist with deep expertise in healthcare claims data to design, build, and deploy advanced analytics and machine learning modeling solutions. In this role, you'll transform complex administrative and clinical datasets into actionable insights that improve cost efficiency, care quality, and operational performance across the healthcare ecosystem.
You'll collaborate with data engineers, clinicians, and product teams to develop predictive models, optimize workflows, and support strategic decision-making. This position is ideal for someone who thrives at the intersection of data science, healthcare operations, and modern machine learning.
Key Responsibilities
Machine Learning & Advanced Analytics
  • Develop, train, and deploy ML models for use cases such as:
  • Claims cost prediction and utilization forecasting
  • Fraud, waste, and abuse detection
  • Risk adjustment and member stratification
  • Provider performance and network optimization
  • Apply modern ML techniques including gradient boosting, deep learning, NLP, and probabilistic modeling.
  • Capable of applying advanced predictive analytics to correlate disparate datasets and events and derive business value.
  • Build scalable pipelines for feature engineering, model training, validation, and monitoring.

Healthcare Claims Expertise
  • Analyze and interpret medical, pharmacy, and dental claims (CPT/HCPCS, ICD-10, DRG, NDC).
  • Translate domain knowledge into meaningful features and model strategies.

Cross-Functional Collaboration
  • Partner with clinicians, product managers, and business stakeholders to define problems and measure outcomes.
  • Communicate complex analytical findings in clear, actionable terms.

Required Qualifications
  • Strong proficiency in Python and ML libraries (scikit-learn, XGBoost, TensorFlow/PyTorch).
  • Hands-on experience with healthcare claims datasets and coding systems.
  • Solid understanding of statistical modeling, machine learning algorithms, and data mining techniques.
  • Strong knowledge and expertise working with SQL.
  • Ability to translate business needs into analytical solutions.
  • Must have demonstrated the ability to solve complex problems with minimal direction.

Preferred Qualifications
  • Experience with NLP applied to clinical notes or unstructured healthcare data.
  • Familiarity with actuarial concepts, risk scoring, or value-based care models.
  • Familiarity deploying models into production (MLOps, CI/CD).
  • Background in health economics, epidemiology, or biostatistics.
  • Prior work with FHIR, HL7, or interoperability standards.

SmartLight Analytics was formed by a group of industry insiders who wanted to make a meaningful impact on the rising cost of healthcare. With this end in mind, SmartLight combats fraud, waste, and abuse in healthcare through our proprietary data analysis and model development. Requiring the bare minimum in employer involvement, our process works behind the scenes to save money without interrupting employee benefits or requiring employee behavior changes.

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