... coding/billing (UB04/1500 form). Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
... coding/billing (UB04/1500 form). Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
... coding/billing (UB04/1500 form). Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
... coding/billing (UB04/1500 form). Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
Director, Medical Economics - REMOTE
Long Beach, CA · On-site +1
$96K - $208K/yr
... coding/billing (UB04/1500 form). • Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
Director, Medical Economics - REMOTE
Long Beach, CA · On-site +1
$96K - $208K/yr
... coding/billing (UB04/1500 form). • Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
Consultant, Medical Economics (Cost Trend & Strategy) - REMOTE
Long Beach, CA · On-site +1
$72K - $156K/yr
... coding/billing (UB04/1500 form). • Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service ...
Consultant, Medical Economics (Cost Trend & Strategy) - REMOTE
Long Beach, CA · On-site +1
$72K - $156K/yr
... coding/billing (UB04/1500 form). • Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service ...
... coding/billing (UB04/1500 form). Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
... coding/billing (UB04/1500 form). Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
Manager, Medical Economics - REMOTE
Long Beach, CA · On-site +1
$79K - $172K/yr
... coding/billing (UB04/1500 form). • Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service ...
Manager, Medical Economics - REMOTE
Long Beach, CA · On-site +1
$79K - $172K/yr
... coding/billing (UB04/1500 form). • Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service ...
... coding/billing (UB04/1500 form). Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
... coding/billing (UB04/1500 form). Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
Senior Analyst, Medical Economics - REMOTE
Long Beach, CA · Remote
$96K - $127K/yr
... coding/billing (UB04/1500 form). Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
Senior Analyst, Medical Economics - REMOTE
Long Beach, CA · Remote
$96K - $127K/yr
... coding/billing (UB04/1500 form). Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis ...
Senior Analyst, Medical Economics - REMOTE
Long Beach, CA · On-site +1
$59K - $129K/yr
... coding/billing (UB04/1500 form). • Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service ...
Senior Analyst, Medical Economics - REMOTE
Long Beach, CA · On-site +1
$59K - $129K/yr
... coding/billing (UB04/1500 form). • Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service ...
Manager, Medical Economics - REMOTE
Long Beach, CA · On-site +1
$79K - $172K/yr
... coding/billing (UB04/1500 form). • Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service ...
Manager, Medical Economics - REMOTE
Long Beach, CA · On-site +1
$79K - $172K/yr
... coding/billing (UB04/1500 form). • Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service ...
Senior Analyst, National Quality Analytics & Performance - Medicare Star Reporting (Remote)
Long Beach, CA · On-site +1
$129K/yr
... and source code changes for data analytics and reporting module, keeping other variables as ... risk adjustment, including experience working with relational databases, Microsoft Transact-SQL (T ...
Senior Analyst, National Quality Analytics & Performance - Medicare Star Reporting (Remote)
Long Beach, CA · On-site +1
$129K/yr
... and source code changes for data analytics and reporting module, keeping other variables as ... risk adjustment, including experience working with relational databases, Microsoft Transact-SQL (T ...
Senior Analyst, National Quality Analytics & Performance - Medicare Star Reporting (Remote)
Long Beach, CA · Remote
Conducts preliminary and post-impact analyses for any logic and source code changes for data ... risk adjustment, including experience working with relational databases, Microsoft Transact-SQL (T ...
Senior Analyst, National Quality Analytics & Performance - Medicare Star Reporting (Remote)
Long Beach, CA · Remote
Conducts preliminary and post-impact analyses for any logic and source code changes for data ... risk adjustment, including experience working with relational databases, Microsoft Transact-SQL (T ...
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Required Qualifications At least 2 years of experience mapping, scrubbing, scrapping, and cleaning data, and analysis experience related to HEDIS and/or risk adjustment, including experience working ...
Required Qualifications At least 2 years of experience mapping, scrubbing, scrapping, and cleaning data, and analysis experience related to HEDIS and/or risk adjustment, including experience working ...
Coder III
Costa Mesa, CA · Remote
Coder III Costa Mesa, CA | 100% Remote Role 3+ Years with a high possibility of extension Description: Position Summary: -Reviews clinical documentation and diagnostic results and applies appropriate ...
Posted today
Quick apply
Coder III
Costa Mesa, CA · Remote
Coder III Costa Mesa, CA | 100% Remote Role 3+ Years with a high possibility of extension Description: Position Summary: -Reviews clinical documentation and diagnostic results and applies appropriate ...
Posted today
Dental Director, Health Plan - REMOTE
Long Beach, CA · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Long Beach, CA · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Long Beach, CA · On-site +1
$129K - $303K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Long Beach, CA · On-site +1
$129K - $303K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Emergency Department Charger/Coder
Los Angeles, CA · On-site +1
$40.04 - $52.83/hr
Los Angeles, CA, USA Onsite or Remote Fully Remote Work Schedule Monday-Friday, 6:00 AM - 3:00 PM ... Support accurate and efficient coding processes to enhance operational success. Elevate your ...
Emergency Department Charger/Coder
Los Angeles, CA · On-site +1
$40.04 - $52.83/hr
Los Angeles, CA, USA Onsite or Remote Fully Remote Work Schedule Monday-Friday, 6:00 AM - 3:00 PM ... Support accurate and efficient coding processes to enhance operational success. Elevate your ...
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 ...
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 ...
Analyst, National Quality Analytics & Performance Improvement (Remote)
Long Beach, CA · On-site +1
$49K - $107K/yr
Required Qualifications • At least 2 years of experience mapping, scrubbing, scrapping, and cleaning data, and analysis experience related to HEDIS and/or risk adjustment, including experience ...
Analyst, National Quality Analytics & Performance Improvement (Remote)
Long Beach, CA · On-site +1
$49K - $107K/yr
Required Qualifications • At least 2 years of experience mapping, scrubbing, scrapping, and cleaning data, and analysis experience related to HEDIS and/or risk adjustment, including experience ...
Remote Risk Adjustment Coder information
See Orange, CA salary details
$19.58 is the 25th percentile. Wages below this are outliers.
$16.95 - $19.63
26% of jobs
$19.63 - $22.32
9% of jobs
$22.32 - $25
12% of jobs
The median wage is $26.34 / hr.
$25 - $27.69
9% of jobs
$27.69 - $30.37
11% of jobs
$30.37 - $33.06
5% of jobs
$35.07 is the 75th percentile. Wages above this are outliers.
$33.06 - $35.74
6% of jobs
$35.74 - $38.43
5% of jobs
$38.43 - $41.11
5% of jobs
$41.11 - $43.79
3% of jobs
$43.79 - $46.48
10% of jobs
$16
$29
$46
How much do remote risk adjustment coder jobs pay per hour?
As of Jul 15, 2026, the average hourly pay for remote risk adjustment coder in Orange, CA is $29.37, according to ZipRecruiter salary data. Most workers in this role earn between $20.29 and $36.97 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?
| 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?
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 the most commonly searched types of Risk Adjustment Coder jobs in Orange, CA? The most popular types of Risk Adjustment Coder jobs in Orange, CA are:
What are popular job titles related to Remote Risk Adjustment Coder jobs in Orange, CA? For Remote Risk Adjustment Coder jobs in Orange, CA, the most frequently searched job titles are:
What job categories do people searching Remote Risk Adjustment Coder jobs in Orange, CA look for? The top searched job categories for Remote Risk Adjustment Coder jobs in Orange, CA are:
What cities near Orange, CA are hiring for Remote Risk Adjustment Coder jobs? Cities near Orange, CA with the most Remote Risk Adjustment Coder job openings:
Full-time
Re-posted 17 days ago
Molina Healthcare rating
8.1
Based on 193 frontline employees who took The Breakroom Quiz
134th of 281 rated insurance
Job description
JOB DESCRIPTION Job Summary
Leads and manages team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
Essential Job Duties
Provides oversight for medical economics team and activities - ensuring delivery of work/project plans and required reporting.
Recruits, hires, onboards, mentors, develops, and manages medical economics staff.
Provides daily management of data management, tools and technology work streams.
Facilitates workload distribution of new reports and project requests.
Coordinates with medical economics team to meet data analysis and database development needs.
Reviews, evaluates, and improves business logic and data sources.
Acts as a resource to team for medical economics/analysis related questions.
Reviews medical economics analysis work products to ensure accuracy and clarity.
Reviews regulatory reporting requirements and health plan project documentation.
Maintains reporting service level benchmarks for enterprise information management (EIM) team.
Represents medical economics department in cross-departmental and operational meetings.
Serves as liaison between EIM and medical economics for reporting needs.
Collects, validates, analyzes, and organizes data into meaningful reports for leadership decision making, and designs, develops, tests and deploys reports to other end users for operational and strategic analysis.
Creates reporting for strategic analysis, profitability, financial analysis, utilization patterns and medical management.
Collaborates with and provides medical economics subject matter expertise for health plans and enterprise teams.
Supports scoreable action item (SAI) initiative tracking to performance.
Required Qualifications
At least 7 years of health care analytics and/or medical economics experience, preferably in claims processing environment and/or health care environment, or equivalent combination of relevant education and experience.
At least 1 year of management/leadership experience.
Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
Demonstrated understanding of Medicaid and Medicare programs or other health care plans.
Analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
Strong knowledge of queries 2005/2008 SSRS and Power BI report development.
Familiar with relational database concepts, and SDLC concepts.
Proficiency with retrieving specified information from data sources.
Experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
Knowledge of health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
Knowledge of health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
Understanding of value-based risk arrangements
Experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
Ability to mine and manage information from large data sources.
Demonstrated problem-solving skills.
Strong critical-thinking and attention to detail.
Ability to effectively collaborate with technical and non-technical stakeholders.
Strong time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
Strong verbal and written communication skills.
Proficient in Microsoft Office suite products, key skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
#PJCorp
#LI-AC1
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
Sourced by ZipRecruiter
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