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Remote Risk Adjustment Coder Jobs in Pasadena, TX

Dane Street, LLC

Certified Professional Coder

Houston, TX · Remote

$21.75 - $29/hr

We are seeking an experienced CPC-certified medical coder with multi-state experience to perform ... Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast ...

Dane Street, LLC

Freelance Medical & Billing Coder

Houston, TX · Remote

$18 - $23.75/hr

Calling all bill review professionals, CPC coders, AAPC, and DRG coders! Dane Street is looking for ... Experience working in a remote environment is preferred. Experience in a medical office or health ...

Astrana Health, Inc.

Business Analyst

Houston, TX · On-site +1

$75K - $85K/yr

... risk adjustment, and value-based care outcomes. * Analyze provider and market data to identify ... This position may operate in a hybrid environment with a combination of office and remote work ...

Astrana Health

Business Analyst

Houston, TX · On-site +1

... risk adjustment, and value-based care outcomes. * Analyze provider and market data to identify ... This position may operate in a hybrid environment with a combination of office and remote work ...

UnitedHealth Group

Coding Analyst - Remote

Houston, TX · Remote

... improving risk management, quality and revenue growth. Ready to help us deliver results that ... 35 coding staff members, both internal and contract as well as remote and/or domestic and global ...

New

UnitedHealth Group

Coding Analyst - Remote

Houston, TX · On-site +1

... improving risk management, quality and revenue growth. Ready to help us deliver results that ... 35 coding staff members, both internal and contract as well as remote and/or domestic and global ...

New

HeartPlace, PLLC

Medical Coder (2823)

Houston, TX · On-site +1

$17 - $22.75/hr

The Coder applies coding conventions per official coding and regulatory guidelines, third-party payer policies, and departmental procedures. This role is responsible for complex surgical coding in ...

YO AI Labs

Pharmacovigilance Expert - Remote

Houston, TX · Remote

$70 - $80/hr

Remote Job Overview We are seeking experienced Pharmacovigilance Experts to contribute their drug ... Benefit-Risk Assessment * MedDRA Coding * Seriousness & Causality Assessment * Expectedness ...

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All JobsRisk Adjustment Coder JobsRemote Risk Adjustment Coder JobsRemote Risk Adjustment Coder Jobs in Pasadena, TX

Remote Risk Adjustment Coder information

See Pasadena, TX salary details

$14

$25

$39

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

As of Sep 7, 2026, the average hourly pay for remote risk adjustment coder in Pasadena, TX is $25.12, according to ZipRecruiter salary data. Most workers in this role earn between $17.36 and $31.63 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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What cities near Pasadena, TX are hiring for Remote Risk Adjustment Coder jobs?

Cities near Pasadena, TX with the most Remote Risk Adjustment Coder job openings:

Remote Risk Adjustment Coder jobs near you

Certified Professional Coder

Dane Street, LLC

Houston, TX • Remote

$21.75 - $29/hr

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

Key responsibilities

  • Perform comprehensive medical coding audits (ICD-10-CM, CPT, HCPCS).

  • Conduct utilization reviews to assess medical necessity and documentation compliance.

  • Review medical records and billing for payer disputes, recoupments, and appeals, and prepare detailed audit reports.

Job description

MUST ALREADY HAVE EXPERIENCE DOING BILL AUDIT REVIEWS FOR DIFFERENT STATES.

We are seeking an experienced CPC-certified medical coder with multi-state experience to perform coding audits, utilization reviews, demand package reviews, and provide litigation support including deposition and testimony services as needed. The ideal candidate must have experience reviewing medical records and billing across multiple states and payer environments.

Responsibilities:

Perform comprehensive medical coding audits (ICD-10-CM, CPT, HCPCS)

Conduct utilization reviews to assess medical necessity and documentation compliance

Review the medical portion and prepare the billing and coding review portion of demand package reviews for personal injury and insurance cases

Analyze medical records for payer disputes, recoupments, and appeals

Prepare detailed, defensible written audit reports

Provide expert review, affidavit support, deposition preparation, and testimony when required

Interpret CMS guidelines, LCD/NCD policies, and state-specific Medicaid and commercial payer rules

Review E/M services under 2021+ guidelines

Identify compliance risks and documentation deficiencies

Requirements

  • Active CPC certification through the American Academy of Professional Coders (AAPC)
  • CPMA strongly preferred
  • Minimum 5-7 years of professional coding experience
  • Documented experience performing audits or utilization reviews in multiple states
  • Strong knowledge of CMS regulations and state Medicaid variations
  • Experience with Medicare, Medicare Advantage, and commercial payer audits
  • Prior demand package review or litigation support experience required
  • Deposition and/or expert testimony history preferred
  • Excellent written reporting and analytical skills
  • Ability to work independently and meet strict deadlines
  • Preferred Experience:
  • RAC, UPIC, or commercial payer audit response
  • Multi-state Medicaid policy interpretation
  • Expert witness experience in civil litigation
  • Data analysis and audit trend reporting
  • This position may be structured as part time Candidates must be comfortable reviewing policies and payer rules across multiple jurisdictions and is able to do multiple types of reviews/audits

Benefits

Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace. 

ABOUT DANE STREET:

A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.

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