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Remote Flexible Risk Adjustment Coder Jobs in New Jersey

Astrana Health, Inc.

$90K - $120K/yr

This position authors and refines the coding policy and documentation standards that govern risk adjustment. You will define how conditions are captured, how documentation must support them, how ...

New

Altegra Health

Remote Certified Coder

Atlantic City, NJ · Remote

$22.50 - $31/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and ...

Altegra Health

Remote Certified Coder

Atlantic City, NJ · On-site +1

$22.50 - $31/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and ...

Stanford Health Care

Risk Adjustment Education * Educates and guides healthcare providers and staff on accurate clinical documentation and coding practices, particularly concerning Hierarchical Condition Categories (HCCs ...

Ennoble Care

Sr. Medical Economics Analyst

Marlton, NJ · Remote

Thorough understanding of and hands-on experience with Medicare risk adjustment and CMS-HCC models ... Fully Remote (with up to 10% travel) This position requires the ability to work with sensitive ...

New

Monogram Health

Market Physician Executive

Newark, NJ · Remote

Flexible vacation time/PSSL * Paid parental leave * Work life assistance resources * Physical ... risk adjustment. * Current state medical license without restrictions to practice and free of ...

RightWay ABA

Medical Billing Specialist ABA

Clifton, NJ · Remote

$21 - $28/hr

Medical Billing Specialist (Remote) Pay: $21-$28 per hour (DOE) About RightWay ABA RightWay ABA is ... Experience working with denial and adjustment codes and clearinghouse workflows. * Excellent ...

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Remote Flexible Risk Adjustment Coder information

What is a remote flexible risk adjustment coder?

A Remote Flexible Risk Adjustment Coder is a healthcare professional who reviews and assigns diagnostic codes to patient records from a remote location, often with flexible hours. Their main role is to ensure that medical diagnoses are accurately captured for risk adjustment purposes, which helps healthcare organizations receive appropriate reimbursement from insurers. They typically analyze electronic health records, identify relevant conditions, and code them based on established guidelines. This job requires knowledge of medical terminology, coding systems like ICD-10, and a strong attention to detail. Working remotely allows for a flexible schedule, making it a popular option for experienced coders.

What skills and qualifications are needed to be a remote flexible risk adjustment coder?

To thrive as a Remote Flexible Risk Adjustment Coder, you need a strong grasp of medical coding standards (ICD-10-CM), risk adjustment models, and a certification such as CPC, CRC, or CCS. Proficiency with coding software, EHR systems, and secure remote communication tools is typically required. Attention to detail, time management, and strong analytical and communication skills help ensure accuracy and effective remote collaboration. These skills are vital for precise coding, regulatory compliance, and supporting accurate healthcare reimbursements in a remote work environment.

How does a remote flexible risk adjustment coder collaborate with healthcare providers and other coding professionals?

As a Remote Flexible Risk Adjustment Coder, collaboration often occurs through secure digital platforms, regular virtual meetings, and shared documentation tools. You may work closely with healthcare providers to clarify medical records and ensure coding accuracy, as well as coordinate with other coders to maintain consistency and compliance. Strong communication skills and responsiveness are essential, as much of the interaction is asynchronous and relies on clear documentation. This teamwork helps ensure accurate risk adjustment coding, supporting healthcare organizations in meeting regulatory and reimbursement standards.

What is the difference between Remote Flexible Risk Adjustment Coder vs Remote Risk Adjustment Coder?

AspectRemote Flexible Risk Adjustment CoderRemote Risk Adjustment Coder
CertificationsAHIMA or AAPC certifications, CPC or CCSSame certifications as flexible role
Work EnvironmentFlexible hours, remote workPrimarily remote, with some flexibility
Employer UsageHealth plans, insurance companies, healthcare providersSimilar employer types, often overlapping
Search IntentFlexible scheduling, remote work optionsGeneral risk adjustment coding roles

The Remote Flexible Risk Adjustment Coder offers more scheduling flexibility compared to the standard Remote Risk Adjustment Coder, while both roles require similar credentials and are used in comparable healthcare settings. The flexible role is ideal for those seeking adaptable hours within the same industry.

Remote Flexible Risk Adjustment Coder jobs near you
Infographic showing various Remote Flexible Risk Adjustment Coder job openings in New Jersey as of August 2026, with employment types broken down into 50% Full Time, 25% Part Time, and 25% Temporary. Highlights an 100% Remote job distribution.

Senior Analyst, Risk Adjustment Strategy

Astrana Health, Inc.

On-site, Remote

$90K - $120K/yr

Full-time

Posted 2 days ago

New

Job description

Senior Analyst, Risk Adjustment Strategy
Department: Quality - Risk Adjustment
Employment Type: Full Time
Location: 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801
Reporting To: Jeremy Jackson
Compensation: $90,000 - $120,000 / year
Description
About the Role
We are currently seeking a highly motivated Risk Adjustment Strategy Senior Analyst. This role will report to the Chief Quality Officer and enable us to continue to scale in the healthcare industry.
This position authors and refines the coding policy and documentation standards that govern risk adjustment. You will define how conditions are captured, how documentation must support them, how ambiguous cases are resolved, and how our coding positions are defended in audit. It is a rule-defining role rather than a production coding role. Our internal coders, clinical documentation reviewers, and provider education teams work from the standards you draft and maintain.
Our Values
• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team
What You'll Do
  • Author, refine, and govern the risk adjustment coding and documentation standards. The working copy of the single source of truth that internal coders, CDI reviewers, and provider education follow across all IPAs managed by the company
  • Translate risk adjustment model specifications and payer requirements into clear, enforceable coding rules, and keep those rules current as models and guidance change
  • Define encounter and source-of-truth rules i.e. which encounter types, provider types, settings, and data sources support a risk-adjustable diagnosis and which do not, documenting the regulatory basis for each
  • Set MEAT/TAMPER documentation criteria by condition category, compliant query rules, and an adjudication path with a versioned decision log, so ambiguous cases are resolved the same way by every coder in every market
  • Establish program guardrails that produce accurate capture not upcoding. This includes chart review scope rules and deletion obligations when review surfaces unsupported codes
  • Own audit defense, chart standards written backwards from the audit, sampling and validation logic, and written position papers defending coding positions when they are challenge
  • Own regulatory change control across ICD-10-CM Official Guidelines, AHA Coding Clinic, and applicable payer and regulatory updates, and drive training and formal attestation for every coder and CDI reviewer on the standard in effect
  • Build the coder quality rubric and inter-rater reliability standard used to measure our internal coding team
  • Build the SQL reporting that sizes opportunity and measures policy impact, coder accuracy, and inter-rater reliability; partner with Compliance, CDI, Data Science, Actuarial/Finance, and Provider Network
  • Keep management apprised of project activities through regular written and oral status reports, and proactively identify compliance and revenue risks that may hinder program success

Qualifications
  • Required Certification/Licensure: Must possess and maintain AAPC Certified Risk Adjustment Coder (CRC) certification. CPC, CCS, RHIA, CDIP, or CCDS is a plus but not required
  • 7+ years of experience in risk adjustment, including direct ownership of coding policy, clinical documentation integrity standards, or audit defense, not solely production coding
  • Demonstrated experience authoring standards that others were required to follow, such as a coding policy manual, coding rules, documentation guidelines, quality rubrics, or audit protocols
  • Working command of risk adjustment model mechanics, including the ability to reason about an unfamiliar model from its published specification
  • Expert ICD-10-CM knowledge, fluent in the Official Guidelines and AHA Coding Clinic, with the judgment to recognize when a payment model's rules are narrower than the code set's
  • Advanced SQL and Excel; comfort working with claims, encounter, supplemental, and pharmacy data
  • Excellent written and verbal communication crafting documents that survive Compliance and Legal review while remaining usable by a coder
  • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems
  • Ability to travel occasionally to our Orange, CA headquarters and, as needed, to other Astrana locations where our coding teams are based (up to 20% of work time)

You're a great fit for the role if:
  • You have owned/authored coding policy
  • You have both payer-side and provider/MSO-side risk adjustment experience
  • You have exposure to encounter data pipelines or managed care plan reporting
  • You understand how program design creates or avoids False Claims Act exposure in risk adjustment
  • You are comfortable declining a revenue-positive idea that the documentation or the model does not support, and can explain the reasoning
  • You default to citation where every standard traces to a regulation, official guideline, model specification, or contract term
  • You write for the reader who must apply the rule, and you would rather define a standard than inherit one
  • You are organized, can prioritize competing high-priority work, and can work in a home office for continuous periods of time for business continuity

Environmental Job Requirements and Working Conditions
  • This position is remotely based in the U.S. The home office is located at 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801.
  • This role is required to attend occasional in-person meetings with internal departments and external providers/hospitals, training, or audit purposes.
  • The national target pay range for this role is between $90,000 - $120,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

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