This is a full-time, remote role working either 6:00 AM - 2:00 PM or 7:00 AM - 3:00 PM EST . If you ... Coder (CPC) required. * Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran
This is a full-time, remote role working either 6:00 AM - 2:00 PM or 7:00 AM - 3:00 PM EST . If you ... Coder (CPC) required. * Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran
This is a full-time, remote role working either 6:00 AM - 2:00 PM or 7:00 AM - 3:00 PM EST. If you ... Coder (CPC) required. Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran
New
This is a full-time, remote role working either 6:00 AM - 2:00 PM or 7:00 AM - 3:00 PM EST. If you ... Coder (CPC) required. Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran
New
This will be a remote position based in Clearfield County requiring 50-75% travel primarily in the ... Coordinate and present education of providers/practices related to risk adjustment, coding, and ...
This will be a remote position based in Clearfield County requiring 50-75% travel primarily in the ... Coordinate and present education of providers/practices related to risk adjustment, coding, and ...
Physician Educator HPL- Remote- Clearfield County, PA & Surrounding Area!
Pittsburgh, PA · On-site +1
$29.92 - $51.79/hr
This will be a remote position based in Clearfield County requiring 50-75% travel primarily in the ... Coordinate and present education of providers/practices related to risk adjustment, coding, and ...
Physician Educator HPL- Remote- Clearfield County, PA & Surrounding Area!
Pittsburgh, PA · On-site +1
$29.92 - $51.79/hr
This will be a remote position based in Clearfield County requiring 50-75% travel primarily in the ... Coordinate and present education of providers/practices related to risk adjustment, coding, and ...
Telehealth Nurse Practitioner
Harrisburg, PA · Remote
$600 - $720/day
Complete risk adjustment documentation (HCC coding) * Close HEDIS care gaps during patient visits ... Fully remote - no commute, no travel * Consistent visit flow and structured workflows Schedule ...
Telehealth Nurse Practitioner
Harrisburg, PA · Remote
$600 - $720/day
Complete risk adjustment documentation (HCC coding) * Close HEDIS care gaps during patient visits ... Fully remote - no commute, no travel * Consistent visit flow and structured workflows Schedule ...
OP CDI Product Manager
Pittsburgh, PA · On-site +1
Strong knowledge of outpatient CDI, ICD-10-CM coding, HCC risk adjustment, quality risk ... Remote Travel: May include up to 10-% Relocation Assistance: Not authorized Must be legally ...
OP CDI Product Manager
Pittsburgh, PA · On-site +1
Strong knowledge of outpatient CDI, ICD-10-CM coding, HCC risk adjustment, quality risk ... Remote Travel: May include up to 10-% Relocation Assistance: Not authorized Must be legally ...
Advanced Practice Provider - Pittsburgh, PA
Pittsburgh, PA · On-site +1
$107K - $120K/yr
Risk Adjustment & Documentation Acumen: Strong knowledge of risk adjustment methodologies and coding principles, coupled with the ability to ensure documentation integrity for compliant medical ...
Advanced Practice Provider - Pittsburgh, PA
Pittsburgh, PA · On-site +1
$107K - $120K/yr
Risk Adjustment & Documentation Acumen: Strong knowledge of risk adjustment methodologies and coding principles, coupled with the ability to ensure documentation integrity for compliant medical ...
Regional Medical Director- (Philadelphia/Baltimore)
Philadelphia, PA · On-site +1
$191K - $355K/yr
Experience with Stars performance, risk adjustment education, or provider engagement * Experience in matrixed environments and cross-functional clinical leadership. Remote work located in ...
Regional Medical Director- (Philadelphia/Baltimore)
Philadelphia, PA · On-site +1
$191K - $355K/yr
Experience with Stars performance, risk adjustment education, or provider engagement * Experience in matrixed environments and cross-functional clinical leadership. Remote work located in ...
Claim Payment Policy Lead - Remote (PA/NJ/DE)
Philadelphia, PA · On-site +1
$19 - $24/hr
Apply appropriate coding sources to recommend and develop comprehensive code assignments in ... Fully Remote: This role is designated by Independence as fully remote. The incumbent will not be ...
Claim Payment Policy Lead - Remote (PA/NJ/DE)
Philadelphia, PA · On-site +1
$19 - $24/hr
Apply appropriate coding sources to recommend and develop comprehensive code assignments in ... Fully Remote: This role is designated by Independence as fully remote. The incumbent will not be ...
Director of Risk
Lancaster, PA · On-site +1
... adjustments. * Oversee reserving practices, claim strategies, and root-cause assessments. Risk ... Remote Work Qualifications * Access to a reliable and secure high-speed internet connection. Cable ...
Director of Risk
Lancaster, PA · On-site +1
... adjustments. * Oversee reserving practices, claim strategies, and root-cause assessments. Risk ... Remote Work Qualifications * Access to a reliable and secure high-speed internet connection. Cable ...
Coder
King Of Prussia, PA · Remote
$18.25 - $24.50/hr
Responsibilities Remote Opportunity Independence Physician Management (IPM), a subsidiary of UHS ... The Coder provides coding services and support to assigned IPM Markets/Billing Entities, as ...
Coder
King Of Prussia, PA · Remote
$18.25 - $24.50/hr
Responsibilities Remote Opportunity Independence Physician Management (IPM), a subsidiary of UHS ... The Coder provides coding services and support to assigned IPM Markets/Billing Entities, as ...
Coder
King Of Prussia, PA · Remote
$18.25 - $24.50/hr
Responsibilities Remote Opportunity Independence Physician Management (IPM), a subsidiary of UHS ... The Coder provides coding services and support to assigned IPM Markets/Billing Entities, as ...
Coder
King Of Prussia, PA · Remote
$18.25 - $24.50/hr
Responsibilities Remote Opportunity Independence Physician Management (IPM), a subsidiary of UHS ... The Coder provides coding services and support to assigned IPM Markets/Billing Entities, as ...
Fully Remote; must be able to accommodate Eastern Time Zone hours. Essential Functions: * Define ... Familiarity with risk adjustment strategy and its impact on product design * Experience launching ...
Fully Remote; must be able to accommodate Eastern Time Zone hours. Essential Functions: * Define ... Familiarity with risk adjustment strategy and its impact on product design * Experience launching ...
Fully Remote; must be able to accommodate Eastern Time Zone hours. Essential Functions: * Define ... Familiarity with risk adjustment strategy and its impact on product design * Experience launching ...
Fully Remote; must be able to accommodate Eastern Time Zone hours. Essential Functions: * Define ... Familiarity with risk adjustment strategy and its impact on product design * Experience launching ...
Professional Fee Coder(Remote PA/NJ)
Allentown, PA · On-site +1
The Physician Coder codes and abstracts physician services performed in the hospital setting according to AHA, AMA, guidelines and CMS directives. Must assure data quality through quarterly reviews.
Professional Fee Coder(Remote PA/NJ)
Allentown, PA · On-site +1
The Physician Coder codes and abstracts physician services performed in the hospital setting according to AHA, AMA, guidelines and CMS directives. Must assure data quality through quarterly reviews.
The Physician Coder codes and abstracts physician services performed in the hospital setting according to AHA, AMA, guidelines and CMS directives. Must assure data quality through quarterly reviews.
The Physician Coder codes and abstracts physician services performed in the hospital setting according to AHA, AMA, guidelines and CMS directives. Must assure data quality through quarterly reviews.
The Physician Coder codes and abstracts physician services performed in the hospital setting according to AHA, AMA, guidelines and CMS directives. Must assure data quality through quarterly reviews.
The Physician Coder codes and abstracts physician services performed in the hospital setting according to AHA, AMA, guidelines and CMS directives. Must assure data quality through quarterly reviews.
Medical Coder
Danville, PA · On-site +1
$21.50 - $28.50/hr
Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for ...
Medical Coder
Danville, PA · On-site +1
$21.50 - $28.50/hr
Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for ...
Coder II - Technical
Pittsburgh, PA · Remote
Coding diagnosis & procedure codes ICD10 & CPT codes and charging for injections, infusions, hydrations, and reconciling NCCI edits. Responsibilities: * Review coding for accuracy and completeness ...
Coder II - Technical
Pittsburgh, PA · Remote
Coding diagnosis & procedure codes ICD10 & CPT codes and charging for injections, infusions, hydrations, and reconciling NCCI edits. Responsibilities: * Review coding for accuracy and completeness ...
Coder II, Profee
Pittsburgh, PA · Remote
As the Coder II, you will review all pertinent physician, nursing, and ancillary documentation. Depending on the type of service and place of service, you will determine the level of acuity ...
Coder II, Profee
Pittsburgh, PA · Remote
As the Coder II, you will review all pertinent physician, nursing, and ancillary documentation. Depending on the type of service and place of service, you will determine the level of acuity ...
Remote Risk Adjustment Coder information
See Pennsylvania salary details
$18.37 is the 25th percentile. Wages below this are outliers.
$15.90 - $18.42
26% of jobs
$18.42 - $20.94
9% of jobs
$20.94 - $23.46
12% of jobs
The median wage is $24.72 / hr.
$23.46 - $25.98
9% of jobs
$25.98 - $28.50
11% of jobs
$28.50 - $31.02
5% of jobs
$32.91 is the 75th percentile. Wages above this are outliers.
$31.02 - $33.54
6% of jobs
$33.54 - $36.06
5% of jobs
$36.06 - $38.58
5% of jobs
$38.58 - $41.09
3% of jobs
$41.09 - $43.61
10% of jobs
$15
$27
$43
How much do remote risk adjustment coder jobs pay per hour?
What are the key skills and qualifications needed to thrive as a Remote Risk Adjustment Coder, and why are they important?
What is a Remote Risk Adjustment Coder?
What is the difference between Remote Risk Adjustment Coder vs Remote Medical Coder?
| Aspect | Remote Risk Adjustment Coder | Remote Medical Coder |
|---|---|---|
| Certifications | AHIMA or AAPC Risk Adjustment certifications | AAPC CPC, CCS, or RHIT certifications |
| Work Environment | Healthcare insurance, payer organizations, risk adjustment teams | Hospitals, clinics, physician offices, insurance companies |
| Industry Usage | Primarily in health insurance and risk adjustment programs | Broad healthcare settings including hospitals and outpatient clinics |
Remote Risk Adjustment Coders focus on analyzing patient data for insurance risk models, requiring specific risk adjustment certifications. Remote Medical Coders handle a wider range of medical records coding across various healthcare settings. While both roles involve medical coding, their industries, certifications, and primary tasks differ significantly.
What are the common challenges faced by Remote Risk Adjustment Coders and how can they be managed?
What Does a Remote Risk Adjustment Coder Do?
As a remote risk adjustment coder, your duties and responsibilities involve performing medical coding and reviewing medical codes for adherence to risk adjustment models. Employers may also expect you to audit medical record data to ensure accuracy. In this role, you work from home to apply codes and make assessments according to regulations and your employer’s operational policies. You also report the results of an audit to the relevant supervisor or coding service provider. It’s your job to ensure compliance with rules related to patient privacy and electronic medical record keeping.

Other
Posted 4 days ago
Job description
At UPMC Health Plan, we're looking for a detail-oriented Certified Coding Specialist I to join our Medicare HCC team. If you enjoy digging into medical records, applying your coding expertise, and making a meaningful impact on data accuracy and patient care-you'll feel right at home here.
This is a full-time, remote role working either 6:00 AM - 2:00 PM or 7:00 AM - 3:00 PM EST. If you're located in another time zone, you'll just need to be comfortable working these Eastern Time hours.
What You'll DoIn this role, you'll play a critical part in ensuring accurate coding and documentation across a variety of care settings. On a typical day, you'll:
- Review inpatient, outpatient, physician, and emergency department records to assign accurate diagnosis and procedure codes
- Apply your expertise in ICD-10-CM, CPT, and HCC risk adjustment coding to ensure proper classification of diagnoses
- Analyze documentation such as discharge summaries, H&Ps, progress notes, consults, and operative reports
- Identify and validate diagnoses submitted through claims by comparing them against clinical documentation
- Audit coding for accuracy and completeness before submission-and make corrections when needed
- Consistently meet quality (95% accuracy) and productivity standards
- Track and maintain your daily coding productivity and time logs
- Use coding tools, systems, and resources to work efficiently and accurately
Your work will directly support accurate risk adjustment and data integrity across the health plan. You'll help ensure that diagnoses are properly captured, which ultimately supports better care planning, reporting, and outcomes.
What Helps You Succeed- Strong knowledge of medical terminology, anatomy, physiology, and pathology
- Confidence working across multiple documentation types and care settings
- A keen eye for detail and commitment to accuracy
- The ability to manage your time independently in a remote environment
- A proactive mindset-you're comfortable identifying issues and helping improve processes
- Ongoing learning opportunities including coding education, seminars, and updated guidelines
- A collaborative team environment where your input and ideas are valued
- Monthly coding meetings to stay aligned and continuously improve
- A structured, process-driven environment with clear expectations and support
If you're ready to bring your coding expertise to a team that values accuracy, collaboration, and continuous improvement-we'd love to hear from you.
- Graduate of an AHIMA or AAPC Certified Coding Program that includes Anatomy & Physiology, Pharmacology and Medical Terminology.
- 5 years of total experience required.
- Five for more years or risk adjustment experience highly preferred.
- Knowledge of Microsoft Office.
Licensure, Certifications, and Clearances: - Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) required.
- Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran
About UPMC Health Plan
Sourced by ZipRecruiter
Industry
Insurance services
Company size
1,001 - 5,000 Employees
Headquarters location
Pittsburgh, PA, US
Year founded
1997