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Remote Risk Adjustment Coder Jobs in Cypress, CA

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Remote Risk Adjustment Coder information

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$16

$29

$46

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

As of Jun 14, 2026, the average hourly pay for remote risk adjustment coder in Cypress, CA is $29.13, according to ZipRecruiter salary data. Most workers in this role earn between $20.14 and $36.68 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
What are popular job titles related to Remote Risk Adjustment Coder jobs in Cypress, CA? For Remote Risk Adjustment Coder jobs in Cypress, CA, the most frequently searched job titles are:
What cities near Cypress, CA are hiring for Remote Risk Adjustment Coder jobs? Cities near Cypress, CA 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 Cypress, CA as of June 2026, with employment types broken down into 79% Full Time, and 21% Contract. Highlights an 100% Remote job distribution, with an average salary of $60,597 per year, or $29.1 per hour.
Senior Specialist, Health Plan Provider Engagement (Remote in NM)

Senior Specialist, Health Plan Provider Engagement (Remote in NM)

Molina Healthcare

Long Beach, CA • On-site, Remote

$49K - $107K/yr

Full-time

Posted 6 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 192 frontline employees who took The Breakroom Quiz

147th of 261 rated insurance

Job description

Job Description
JOB SUMMARY:
Provides senior level support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes Uses a consultative approach emphasizing physician engagement and behavior change through actionable data and analytics. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to improve performance through regular meetings and action plans. Addresses practice environment challenges to achieve program goals and improve health outcomes. Tracks engagement activities using standard tools, facilitates data exchanges, and supports training and problem resolution for assigned providers - driving provider participation in Molina's risk adjustment and quality initiatives.
ESSENTIAL JOB DUTIES:
  • Provides support for provider engagement activities including enhancing value-based strategies, and risk adjustment/quality improvement initiatives.
  • Ensures assigned Tier 1, Tier 2, and where applicable Tier 3, providers have a provider engagement plan to meet annual quality and risk adjustment performance goals.
  • Drives provider partner coaching and collaboration to improve Medicaid, Medicare and Marketplace quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution.
  • Works with provider front-office staff to get the Molina members with the most open gaps on the schedule and seen by their assigned provider. Coordinates with Health Plan Community and Member Engagement resources to drive supporting effort on the member side.
  • Addresses challenges/barriers in the practice environment impeding successful attainment of program goals and understands solutions required to improve health outcomes.
  • Drives provider participation in Molina risk adjustment and quality efforts (e.g. supplemental data, electronic medical record (EMR) connection, clinical profiles programs) and use of the Molina provider collaboration portal.
  • Tracks all engagement and training activities using standard Molina provider engagement tools to measure effectiveness both within and across Molina health plans.
  • Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
  • Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
  • Accountable for use of standard Molina Provider Engagement reports and training materials.
  • Develops, organizes, analyzes, documents and implements processes and procedures as prescribed by health plan and corporate policies.
  • Communicates comfortably and effectively with internal and external stakeholders, including physician leaders, providers, practice managers, and medical assistants within assigned provider practices.
  • Provides training and support for new and existing practice transformation and provider engagement team members.
  • Maintains the highest level of compliance.
  • May require same day out-of-office travel up to 25% of the time, depending upon state/health plan requirements.

REQUIRED QUALIFICATIONS:
  • At least 3 years of experience improving population-level HEDIS quality scores and burden of illness documentation accuracy through provider engagement, or equivalent combination of relevant education and experience.
  • Experience with various managed health care provider compensation methodologies including but not limited to: fee-for service (FFS), value-based care (VBC), and capitation.
  • Working knowledge of quality metrics and risk adjustment practices across all business lines.
  • Knowledge and understanding of HEDIS/NCQA and/or CMS STARs quality measures and risk adjustment practices across Medicaid, Medicare and Marketplace.
  • Proficiency with data analysis, manipulation, interpretation and reporting.
  • Critical-thinking, problem-solving and analytical skills.
  • Relationship building skills.
  • Attention to detail and organizational skills.
  • Ability to implement process improvement initiatives and drive change.
  • Ability to work independently in a fast-paced, deadline-driven environment.
  • Ability to foster and build relationships in a cross-functional highly matrixed organization to obtain buy-in and drive results
  • Effective verbal and written communication skills.
  • Microsoft Office suite (including Excel), Power BI, and other applicable software programs proficiency, and ability to learn new information systems and software programs.

PREFERRED QUALIFICATIONS:
  • Bachelor's degree in Nursing, Health Administration or relevant discipline.
  • Solid understanding of health insurance, provider messaging/design and project management.
  • Strong experience using Microsoft products, including Excel (knowledge of pivot tables, VLOOKUP, etc.) and PowerPoint.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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