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Per Diem Risk Adjustment Specialist Jobs (NOW HIRING)

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the ... The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee ...

Vertek Staffing

HCC Risk Adjustment Coder

Franklin, TN · Remote

$18 - $24/hr

Certified Coding Specialist (CCS) - AHIMA * Registered Health Information Technician (RHIT) - AHIMA * Registered Health Information Administrator (RHIA) - AHIMA CRC Certification is highly preferred.

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the ... The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee ...

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Per Diem Risk Adjustment Specialist information

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$38K

$100.5K

How much do per diem risk adjustment specialist jobs pay per year?

As of Aug 9, 2026, the average yearly pay for per diem risk adjustment specialist in the United States is $94,940.00, according to ZipRecruiter salary data. Most workers in this role earn between $98,500.00 and $98,500.00 per year, depending on experience, location, and employer.

What is a per diem risk adjustment specialist?

A Per Diem Risk Adjustment Specialist is a healthcare professional who works on an as-needed basis to review and analyze patient medical records for accurate documentation and coding. Their primary role is to ensure that diagnoses are properly captured for risk adjustment purposes, which affects healthcare reimbursement and quality measures. They often work remotely or on-site for healthcare organizations, focusing on compliance with regulatory standards and accuracy in coding practices. This position requires detailed knowledge of medical coding, risk adjustment models, and healthcare regulations.

What are the key skills and qualifications needed to thrive as a per diem risk adjustment specialist?

To thrive as a Per Diem Risk Adjustment Specialist, you need a solid understanding of medical coding (ICD-10), health information management, and risk adjustment methodologies, typically supported by a coding certification such as CPC or CRC. Familiarity with electronic health records (EHRs), coding software, and risk adjustment platforms is essential for accurate data capture and reporting. Strong attention to detail, analytical thinking, and effective communication skills help ensure the integrity of clinical documentation and collaboration with providers. These skills are crucial for optimizing reimbursement, supporting regulatory compliance, and contributing to accurate patient risk profiling in healthcare organizations.

What are some common challenges faced by per diem risk adjustment specialists, and how can they be addressed?

Per Diem Risk Adjustment Specialists often face the challenge of managing fluctuating workloads and adapting quickly to different healthcare settings or documentation systems. Since the role typically involves reviewing medical records for accuracy and completeness, staying updated on coding guidelines and payer requirements is crucial. To succeed, it's helpful to maintain strong organizational skills, be proactive in continuing education, and communicate effectively with permanent staff to clarify documentation or coding questions. Flexibility and attention to detail are key assets for overcoming these challenges and ensuring accurate risk adjustment reporting.

What is the difference between Per Diem Risk Adjustment Specialist vs Per Diem Claims Processor?

AspectPer Diem Risk Adjustment SpecialistPer Diem Claims Processor
Primary FocusAnalyzing and optimizing risk adjustment data for health plansProcessing daily insurance claims and payments
Required CredentialsKnowledge of healthcare coding, risk adjustment, and data analysisUnderstanding of claims processing and insurance policies
Work EnvironmentHealthcare offices, insurance companies, or remoteInsurance companies, healthcare providers, or remote
Industry UsageCommonly used in health insurance and risk adjustment sectorsUsed across insurance claims processing departments

The Per Diem Risk Adjustment Specialist focuses on analyzing risk data to improve health plan reimbursements, while the Per Diem Claims Processor handles daily claims processing tasks. Both roles are essential in healthcare insurance operations but differ in their core responsibilities and skill sets.

More about Per Diem Risk Adjustment Specialist jobs
What cities are hiring for Per Diem Risk Adjustment Specialist jobs? Cities with the most Per Diem Risk Adjustment Specialist job openings:
What are the most commonly searched types of Risk Adjustment Specialist jobs? The most popular types of Risk Adjustment Specialist jobs are:
What states have the most Per Diem Risk Adjustment Specialist jobs? States with the most job openings for Per Diem Risk Adjustment Specialist jobs include:
What job categories do people searching Per Diem Risk Adjustment Specialist jobs look for? The top searched job categories for Per Diem Risk Adjustment Specialist jobs are:
Per Diem Risk Adjustment Specialist jobs near you
Infographic showing various Per Diem Risk Adjustment Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 88% Full Time, 8% Part Time, and 3% Contract. Highlights an 88% Physical, 4% Hybrid, and 8% Remote job distribution, with an average salary of $94,940 per year, or $45.6 per hour.

Auditor, Risk Adjustment

Oscar Health

Dallas, TX • Remote

$82K - $108K/yr

Full-time

Re-posted 11 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

251st of 304 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.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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