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Remote Risk Adjustment Coder Jobs in Wisconsin (NOW HIRING)

CorVel

Customer Service Representative I

Waukesha, WI · Remote

$13.94 - $21.48/hr

This is a remote position. This role requires internet upload and download speeds of at least ... Medical terminology and coding knowledge EDUCATION & EXPERIENCE: * High school diploma or ...

Corvel

Indemnity Claims Specialist

Madison, WI · Remote

$51.81K - $83.55K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives claims, confirms ... The level may impact the salary range and these adjustments would be clarified during the offer ...

Highmark Health

Supervisor Coding

Madison, WI · Remote

$48.54/hr

Associates Degree in a Health Information related field or 4 years of experience in lieu of Associate's degree * 3 years experience as a production coder related to the coding team being supervised ...

WPS Health Solutions

Claims Examiner II

Madison, WI · On-site +1

$17.75/hr

Initiate adjustments, reprocesses and serve as resource for other teams. Minimum Qualifications * U ... Coding or Medical Assistant. Remote Work Requirements * High speed cable or fiber internet

Corvel

Care Advocate Nurse

Madison, WI · Remote

$61.05K - $98.33K/yr

This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Initiates and receives telephonic ... The level may impact the salary range and these adjustments would be clarified during the offer ...

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

As of May 31, 2026, the average hourly pay for remote risk adjustment coder in Wisconsin is $27.75, according to ZipRecruiter salary data. Most workers in this role earn between $19.18 and $34.95 per hour, depending on experience, location, and employer.

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.

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

To thrive as a Remote Risk Adjustment Coder, you need a solid understanding of ICD-10-CM coding, medical terminology, and risk adjustment models, often supported by a coding certification such as CPC, CRC, or CCS. Proficiency with electronic health record (EHR) systems, coding software, and data management tools is essential. Attention to detail, strong analytical skills, and effective communication are crucial soft skills for accurate code assignment and collaboration with healthcare teams. These skills ensure compliance, maximize reimbursement, and support quality healthcare outcomes in a remote environment.

What are the common challenges faced by Remote Risk Adjustment Coders and how can they be managed?

Remote Risk Adjustment Coders often encounter challenges such as interpreting complex medical records, ensuring coding accuracy under tight deadlines, and staying updated with evolving coding guidelines. Managing these challenges typically involves strong attention to detail, proactive communication with team members, and participating in ongoing training sessions or webinars. Utilizing supportive resources and adhering to standardized coding protocols can help coders maintain accuracy and efficiency in a remote setting.

What is a Remote Risk Adjustment Coder?

A Remote Risk Adjustment Coder is a healthcare professional who reviews patient medical records and assigns diagnostic codes from a remote location, typically from home. Their primary goal is to ensure accurate coding for risk adjustment purposes, which helps health plans predict patient healthcare costs and receive appropriate funding. These coders work with electronic health records and must be knowledgeable about coding standards like ICD-10-CM. They play a key role in supporting compliance and maximizing revenue for healthcare organizations. Attention to detail, confidentiality, and proficiency with coding software are essential skills for this remote position.

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

AspectRemote Risk Adjustment CoderRemote Medical Coder
CertificationsAHIMA or AAPC Risk Adjustment certificationsAAPC CPC, CCS, or RHIT certifications
Work EnvironmentHealthcare insurance, payer organizations, risk adjustment teamsHospitals, clinics, physician offices, insurance companies
Industry UsagePrimarily in health insurance and risk adjustment programsBroad 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.

More about Remote Risk Adjustment Coder jobs
What are popular job titles related to Remote Risk Adjustment Coder jobs in Wisconsin? For Remote Risk Adjustment Coder jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Remote Risk Adjustment Coder jobs in Wisconsin look for? The top searched job categories for Remote Risk Adjustment Coder jobs in Wisconsin are:
What cities in Wisconsin are hiring for Remote Risk Adjustment Coder jobs? Cities in Wisconsin with the most Remote Risk Adjustment Coder job openings:
Remote Risk Adjustment Coder jobs near you
Infographic showing various Remote Risk Adjustment Coder job openings in Wisconsin as of May 2026, with employment types broken down into 75% Full Time, 21% Part Time, and 4% Contract. Highlights an 8% Physical, and 92% Remote job distribution, with an average salary of $57,717 per year, or $27.7 per hour.

Account Resolution Rep II PB Dental-Remote

Children's Wisconsin

West Allis, WI • Remote

$14.25 - $19.50/hr

Full-time

Posted 19 days ago

Children's Wisconsin rating

7.3

Company rating: 7.3 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

345th of 990 rated hospitals

Job description

At Children's Wisconsin, we believe kids deserve the best.

Children's Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.

We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.

Please follow this link for a closer look at what it's like to work at Children's Wisconsin:https://www.instagram.com/lifeatcw/

Job Summary:

Researches and resolves Professional Billing complex service insurance denials and ensures that dental claims are paid at maximum reimbursement from third party payers, state programs and contracted organizations for Children's Wisconsin.

Essential Functions:

  • Performs various follow-up actions including contacting guarantors, insurance companies, updating registration, correcting and resubmitting claims, filing appeals in order to achieve claim resolution.

  • Maintains current knowledge of managed care payer contracts and third party payer billing guidelines and policies for assigned payers (Commercial/Government).

  • Follows-up on assigned work queues to ensure proper reimbursement based on assigned payer timely filing guidelines.

  • Identifies coding issues relating to CDT codes and use of appropriate modifiers to obtain maximum reimbursement. Collaborates with leadership and coding team on resolution.

  • Analyzes and investigates complex insurance denials, identify and/or track trends associated to assigned payers. Keeping leads and management appraised of identified issues having an impact on reimbursement.

  • Submits written and online correspondences and appeals to payers as needed to obtain appropriate payment.

  • Reviews and recommends adjustments of claims to management. Applies account adjustments when appropriate.

  • Utilizes payer websites to verify patient insurance information, claim status/payments/denials and/or to appeal online as necessary to obtain proper payment on claims.

  • Maintains a thorough understanding of A/R functions, department policies and procedures. Maintains productivity and quality standards as set by management.

Education:

  • High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED) Required or

Experience:

  • 2+ years experience in claims follow up in health care revenue cycle operations including reimbursement procedures and comprehension of insurance EOB's Required

  • Prior experience in a hospital system working with professional billing claims and functions Preferred

  • Dental and orthodontics billing experience Preferred

  • Experience in Epic Resolute Preferred

Knowledge, Skills and Abilities:

  • Working knowledge of medical terminology, ICD-10, CPT and HCPCS level II codes.

  • Strong understanding of payer guidelines, policies and procedures.

  • Excellent verbal and written communication skills.

  • Ability to work independently with minimal supervision.

  • Strong analytical skills and ability to perform noncomplex arithmetic calculations when determining contractual allowances.

  • Must have working knowledge of account reconciliation and third party reimbursements from Commercial, Medicaid and Medicare Carriers.

  • Interpersonal skills necessary to efficiently respond to questions from patients, parents, clinic staff and insurance companies to effectively resolve billing issues.

  • The ability to multi-task and function effectively in a team environment and maintain effective relationships with coworkers, patients, physicians, management, staff and other customers.

  • Proficient in Microsoft Office applications and technology skills required to perform duties.

Required for All Jobs:

  • This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that may be requested in the performance of this job.

  • Employment is at-will. This document does not create an employment contract, implied or otherwise.

  • 2+ years' experience in claims follow up
  • Dental or Orthodontics billing experience
  • Fully Remote Work Opportunity
  • Flexible

Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.

Certifications/Licenses:

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