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Remote Flexible Risk Adjustment Coder Jobs in Ohio

Huntington

Market Risk Analytics Manager

Columbus, OH · On-site +1

... flexible work arrangement. We're combining the best of both worlds: in-office and work from home ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

CareSource

Applied AI Scientist III

Dayton, OH · On-site +1

... expertise and code reviews. Essential Functions: * Evaluate emerging technology in LLMs, NLP ... Work closely with interdisciplinary teams across IT, risk adjustment, program integrity, HEDIS ...

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Remote Flexible Risk Adjustment Coder information

What are the key skills and qualifications needed to thrive as a Remote Flexible Risk Adjustment Coder, and why are they important?

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.

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.

How does a Remote Flexible Risk Adjustment Coder typically 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 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 are popular job titles related to Remote Flexible Risk Adjustment Coder jobs in Ohio? For Remote Flexible Risk Adjustment Coder jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Remote Flexible Risk Adjustment Coder jobs in Ohio look for? The top searched job categories for Remote Flexible Risk Adjustment Coder jobs in Ohio are:
What cities in Ohio are hiring for Remote Flexible Risk Adjustment Coder jobs? Cities in Ohio with the most Remote Flexible Risk Adjustment Coder job openings:
Remote Flexible Risk Adjustment Coder jobs near you
Infographic showing various Remote Flexible Risk Adjustment Coder job openings in Ohio as of July 2026, with employment types broken down into 1% As Needed, 77% Full Time, 16% Part Time, and 6% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution.
Quality Risk Adjustment Advisor IV (Health Plan experience required)

Quality Risk Adjustment Advisor IV (Health Plan experience required)

CareSource

Dayton, OH • On-site, Remote

$83K - $132K/yr

Full-time

Posted 12 days ago

CareSource rating

7.7

Company rating: 7.7 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

180th of 277 rated insurance

Job description

Job Summary:
The Quality Risk Adjustment Advisor IV is responsible for leading key components of the Quality Risk Adjustment (QRA) programs, including prospective programs, chart retrieval and coding processes, while ensuring compliance with regulatory standards and optimizing quality outcomes. This role partners closely with internal stakeholders and external vendors to enhance operational effectiveness and leverage artificial intelligence (AI) technologies to improve data accuracy, efficiency, and overall program performance.
Essential Functions:
  • Serve as a subject matter expert in Risk Adjustment operations, supporting prospective programs, chart retrieval and coding processes.
  • Identify and recommend strategies to optimize risk adjustment processes and improve quality metrics across insourced and outsourced activities, including leveraging AI for process enhancement.
  • Partner with vendors to support execution of operational production plans and contractual requirements.
  • Monitor vendor performance and identify opportunities to improve efficiency, quality, and cost management.
  • Collaborate with QRA Compliance to support development and maintenance of quality assurance protocols.
  • Conduct audits and assessments to ensure accuracy, completeness, and efficiency.
  • Research and evaluate technological solutions, including AI/NLP tools.
  • Partner with Data Science, IT, and Sourcing teams to support deployment of AI solutions.
  • Collaborate with cross-functional teams to support operational goals.
  • Identify and implement process improvements.
  • Monitor and analyze key performance indicators (KPIs).
  • Gather and translate business requirements into actionable recommendations.
  • Assess build vs. buy AI solutions.
  • Support evaluation and monitoring of AI solution performance.
  • Provide guidance and informal coaching to stakeholders as needed.
  • Perform any other job related duties as requested.

Education and Experience:
  • Bachelor's degree in Health Administration, Healthcare Management, or a related field required
  • Master's degree is preferred
  • Equivalent years of relevant work experience may be accepted in lieu of required education
  • Seven (7) years experience in risk adjustment, medical record review, coding, or quality management required
  • Two (2) years experience with AI solutions in a healthcare setting required
  • Leadership experience preferred
Competencies, Knowledge and Skills:
  • Knowledge of ICD-10 Coding
  • Knowledge of HCC Risk Adjustment models
  • Knowledge of CMS regulatory guidelines
  • Strong analytical and problem-solving skills
  • Ability to apply AI technologies in healthcare
  • Strong communication and collaboration skills
  • Ability to influence stakeholders without direct authority
Licensure and Certification:
  • None
Working Conditions:
  • General office environment; may be required to sit or stand for extended periods of time
  • Travel is not typically required

Compensation Range:
$83,000.00 - $132,800.00
CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
  • Fostering a Collaborative Workplace Culture
  • Cultivate Partnerships
  • Develop Self and Others
  • Drive Execution
  • Influence Others
  • Pursue Personal Excellence
  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
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