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Remote Risk Adjustment Coder Jobs in Carnegie, PA

Solventum

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 ...

Corporate Revenue Cycle

Coder II - Profee

Pittsburgh, PA · Remote

$18.25 - $24.25/hr

As a Coder II, you will review all pertinent physician, nursing and ancillary documentation in the medical record. Depending on type of service and place of service, you will determine the level of ...

Rayus Radiology

Billing Coordinator

Wexford, PA · Remote

This is a 100% remote, full-time position working; Monday - Friday 8:00 AM - 4:30 PM. ESSENTIAL ... Reviews information packets received from field offices for accuracy of ICD-10 and CPT coding ...

BNY

Senior Vice President, Research - IM

Pittsburgh, PA · On-site +1

$155K/yr

Remote work may be permitted within a commutable distance from the worksite. REQUIREMENTS: Bachelor ... Utilizing risk management frameworks involving Value at Risk (VaR), and stress testing/scenario ...

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Remote Risk Adjustment Coder information

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$15

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$41

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

As of Jun 29, 2026, the average hourly pay for remote risk adjustment coder in Carnegie, PA is $26.36, according to ZipRecruiter salary data. Most workers in this role earn between $18.22 and $33.17 per hour, depending on experience, location, and employer.

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 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.

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 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.

More about Remote Risk Adjustment Coder jobs
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Remote Risk Adjustment Coder jobs near you
Certified Coding Specialist I (Risk Adjustment)

Certified Coding Specialist I (Risk Adjustment)

UPMC Health Plan

Pittsburgh, PA • Remote

Other

Posted 25 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 Do

In 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
How You'll Make an Impact

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
What Else to Expect
  • 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

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