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Remote Medicare Risk Adjustment Jobs (NOW HIRING)

Centene

Risk Adjustment Auditor Educator

$56K - $101K/yr

... Medicare risk adjustment (HCC Coding) Required Other experience in teaching, training or an ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ...

Insight Global

REMOTE Risk Adjustment Coder

Tampa, FL · Remote

$23 - $25/hr

Insight Global is hiring experienced and CPC certified Risk Adjustment Coding Specialist (HCC) to support Medicare Advantage risk adjustment initiatives. This role will focus primarily on concurrent ...

Mercor

HCC Coding Leader - Risk Adjustment

New York, NY · Remote

$110/hr

Remote Role Responsibilities * Lead risk adjustment and HCC coding operations across Medicare Advantage , Medicaid , and ACA risk adjustment programs. * Evaluate AI-generated HCC coding assignments ...

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82K - $108K/yr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ...

Mercor

Risk Adjustment Expert - AI Trainer

Nashville, TN · Remote

$110/hr

Remote Role Responsibilities * Lead risk adjustment and HCC coding operations across Medicare Advantage , Medicaid , and ACA risk adjustment programs. * Evaluate AI-generated HCC coding assignments ...

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82K - $108K/yr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ...

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82K - $108K/yr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record ...

Vertek Staffing

HCC Risk Adjustment Coder

Franklin, TN · Remote

$18 - $24/hr

HCC / Risk Adjustment Coder - Remote Risk Adjustment / HCC Coding Experience Required Required ... Experience with Medicare Advantage populations * Experience with value-based care programs

Molina Healthcare

Auditor, Risk Adjustment (Remote)

$49K - $107K/yr

... Medicare and Medicaid Services (CMS) regulations and guidelines of risk adjustment data. • Identifies opportunities for data mining to ensure data gaps are minimized. • Applies best practices to ...

US Tech Solutions

Medical Billing Coder

Wellesley, MA · Remote

$20.50 - $27.50/hr

Medical Record Reviewer will primarily be responsible for completing medical record reviews (on-site, remote and/or in-house) in support of the Medicare risk adjustment retrospective initiative and ...

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Remote Medicare Risk Adjustment information

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How much do remote medicare risk adjustment jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for remote medicare risk adjustment in the United States is $21.50, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $22.84 per hour, depending on experience, location, and employer.

What is the difference between Remote Medicare Risk Adjustment vs Remote Medical Coding Specialist?

AspectRemote Medicare Risk AdjustmentRemote Medical Coding Specialist
CertificationsCPR, CPC, or RAC certifications often preferredCPC, CCS, or CCS-P certifications
Work EnvironmentHealthcare insurance companies, Medicare plansHospitals, clinics, insurance companies
Industry UsagePrimarily in Medicare risk adjustment programsMedical billing and coding across various healthcare settings

Remote Medicare Risk Adjustment and Remote Medical Coding Specialist roles share certifications and healthcare industry usage but differ in focus. Medicare Risk Adjustment involves analyzing patient data to optimize Medicare plan reimbursements, while Medical Coding Specialists translate medical records into billing codes. Both roles require healthcare knowledge but serve distinct functions within the healthcare revenue cycle.

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Remote Medicare Risk Adjustment jobs near you
Infographic showing various Remote Medicare Risk Adjustment job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $44,724 per year, or $21.5 per hour.

HEALTH CODER - HCC & RISK ADJUSTMENT

Burlingame, CA • Remote

NORTH EAST MEDICAL SERVICES
Health Care and Social Assistance • 51 - 200 employees
Learn more about NORTH EAST MEDICAL SERVICESexternal

$42.79 - $48.75/hr

Full-time

Re-posted 10 days ago

Job description

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization’s quality outcomes and financial performance.

ESSENTIAL JOB FUNCTIONS:

  • HCC Coding and Risk Adjustment (RA) Program Support
    • Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
    • Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
    • Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
  • Provider Training and Clinical Documentation Improvement (CDI)
  • Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
  • Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
  • Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
  • Data Analysis and Reporting
    • Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
    • Generate reports and dashboards to track coding performance and documentation accuracy.
    • Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
  • Compliance and Continuous Improvement
    • Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
    • Assist in the development and implementation of internal coding policies and procedures.
    • Participate in quality improvement initiatives related to coding and documentation.
    • Performs other job duties as required by manager/supervisor
  • Education & Certification:
    • BS/BA Degree in Health Science or General Education is required. 
    • Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
    • Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
  • Experience:
    • Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
    • Experience in provider education, clinical documentation improvement (CDI), and chart audits.
    • Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
  • Skills & Competencies:
    • Excellent communication, presentation, and interpersonal skills.
    • Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
    • Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
    • Proficiency in electronic health records (EHR) and coding software.
    • Strong analytical and problem-solving skills.

LANGUAGE:

  • Must be able to fluently speak, read and write English.
  • Fluency in other languages is an asset.

STATUS:

  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This a full-time position. 

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