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Remote Risk Adjustment Coder Jobs in Alhambra, CA

Urrly

Telehealth Nurse Practitioners

Los Angeles, CA · On-site +1

$600 - $720/day

Document risk adjustment (HCC coding) during patient visits * Close HEDIS care gaps during visits ... Fully remote work - no commute * Consistent visit flow and structured workflows * Clear ...

YO AI Labs

Medical Coder - Remote

Los Angeles, CA · Remote

$50 - $80/hr

Medical Coder Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Coders to contribute their healthcare coding expertise to an innovative project focused on ...

Seen Health

Head of Data

Los Angeles, CA · On-site +1

Own the analytics behind risk adjustment and clinical quality: HCC/RAF capture, care gap closure ... BigQuery), infrastructure-as-code (e.g. Terraform), cloud storage (e.g. GCS), and BI (e.g. Metabase)

UCLA Health

Outpatient Coder - Per Diem

Los Angeles, CA · On-site +1

$47.60 - $62.78/hr

Los Angeles, CA, USA Onsite or Remote Fully Remote Work Schedule Monday - Friday, 6:00 AM - 3:00 PM ... You will be responsible for coding diagnoses and procedures for assigned cases. This will involve ...

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Remote Risk Adjustment Coder information

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$16

$28

$45

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

As of Aug 26, 2026, the average hourly pay for remote risk adjustment coder in Alhambra, CA is $28.99, according to ZipRecruiter salary data. Most workers in this role earn between $20.05 and $36.49 per hour, depending on experience, location, and employer.

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 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?

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 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.

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Remote Risk Adjustment Coder jobs near you
Infographic showing various Remote Risk Adjustment Coder job openings in Alhambra, CA as of August 2026, with employment types broken down into 1% As Needed, 88% Full Time, 8% Part Time, and 3% Contract. Highlights an 88% Physical, 4% Hybrid, and 8% Remote job distribution, with an average salary of $60,305 per year, or $29 per hour.

Senior Analyst, Risk Adjustment Strategy

Alhambra, CA • Remote

Astrana Health, Inc.
See more jobs at Astrana Health, Inc.external

$90K - $120K/yr

Full-time

Posted 6 days ago

Job description

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.