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Remote Risk Adjustment Coder Jobs in Prosper, TX

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Cybersecurity SME[Remote]

Dallas, TX · Remote

Remote (May require Occasional Travel) Interview Mode: MS Teams Video Call Approximate Duration: 6+ ... movement risk. * Apply ABAC/ReBAC and policy as code (e.g., OPA) for APIs and event driven ...

USAA

Tax Analyst Senior

Plano, TX · On-site +1

$93K - $179K/yr

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... adjustments, and completing required forms and schedules. * Leads high-risk tax audit issues in ...

USAA

Tax Analyst Senior

Plano, TX · On-site +1

$93K - $179K/yr

USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with ... adjustments, and completing required forms and schedules. * Leads high-risk tax audit issues in ...

Toyota

Senior Analyst - Analytics

Plano, TX · On-site +1

$84K - $111K/yr

... I-140 or Adjustment of Status portability), etc. now or in the future. You should not apply for ... Professional experience coding in SQL and Python (tested during interviews). * Professional ...

Corvel

Data Verification Analyst

Dallas, TX · Remote

$13.38 - $23.42/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Validate incoming data to the ... The level may impact the salary range and these adjustments would be clarified during the offer ...

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Remote Risk Adjustment Coder information

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

As of Aug 5, 2026, the average hourly pay for remote risk adjustment coder in Prosper, TX is $25.18, according to ZipRecruiter salary data. Most workers in this role earn between $17.40 and $31.68 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a remote risk adjustment coder?

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.

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Remote Risk Adjustment Coder jobs near you

Multi-Line Claims Adjuster - Commercial Auto & GL/BI - Remote

CCMSI

Dallas, TX • On-site, Remote

$75K - $85K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 26 days ago

Job description

Overview
Multi-Line Claim Consultant - National Accounts
Compensation: $75,000-$85,000 annually (based on experience)
Schedule: Monday-Friday
Work Model: Fully Remote
Jurisdictions: All except AK
Industry: Commercial Auto / General Liability
Build Your Career With Purpose at CCMSI
At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.
We don't just process claims-we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work®, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.
Job Summary
The Multi-Line Claim Consultant is responsible for the investigation, evaluation, and adjustment of assigned multi-line claims across multiple disciplines, including Auto, Commercial Auto, General Liability (GL), and Bodily Injury (BI). This role supports a multi-client desk (up to four national accounts) across all states and requires the ability to shift between claim types throughout the day while maintaining quality and compliance.
This position plays a critical role in delivering high-quality claim services aligned with CCMSI corporate standards and client expectations. Exposure to potentially litigated claims is expected. The role may also serve as a developmental opportunity for advancement into senior-level claim positions.
This is a fully remote position, Monday through Friday, with core businss hours being 8am to 4:30pm. A valid adjuster license is required.
Please note: This is a claims adjuster role, responsible for cradle-to-grave liability claim handling. It is not an HR, consulting, or employer-side position.
Responsibilities
When we hire adjusters, we look for professionals who take ownership of their work, navigate complex claims with confidence, and deliver exceptional service with integrity. In this role, you'll manage your files independently while contributing to a collaborative, high-performing team.
What You'll Do
  • Investigate, evaluate, and adjust multi-line liability claims (property damage & bodily injury) in accordance with CCMSI standards and state requirements.
  • Manage claims involving commercial vehicles, trucking exposures, and third-party liability.
  • Determine coverage, assess liability, and develop defensible claim strategies.
  • Review medical, legal, and vendor invoices for accuracy and reasonableness; negotiate discrepancies as needed.
  • Establish, monitor, and adjust reserves in alignment with exposure and authority guidelines.
  • Negotiate settlements with claimants, attorneys, and representatives in accordance with client expectations.
  • Engage, coordinate, and manage defense counsel or other external vendors when appropriate.
  • Identify and pursue subrogation opportunities.
  • Maintain detailed and timely claim documentation, diary management, and financial reporting.
  • Support excess reporting requirements and client communication needs.
  • Deliver consistent, high-quality service with professionalism and integrity.

Qualifications
What You Bring
Required
  • Active adjuster license in home state required (multi-state licensing preferred)
  • Experience managing a multi-client desk and navigating varying client expectations
  • 5+ years of multi-lin claims experience is required (Auto, Commerical Auto, GL, BI)
  • Strong analytical, negotiation, and decision-making skills
  • Strong ability to handle diverse claim types and pivot quickly throughout the workday
  • Ability to analyze coverage and communicate claim decisions clearly and professionally
  • Excellent time-management and organizational abilities
  • Strong written and verbal communication skills
  • Ability to work independently in a remote environment with strong accountability
  • Reliable, predictable attendance during business hours

Preferred
  • Litigation experience preferred
  • Third Party Administrator (TPA) experience preferred
  • New York adjuster license (nice to have)
  • Experience performing coverage evaluations and coverage position analysis
  • Comfort reviewing and applying contractual risk transfer, indemnification, and additional insured concepts
  • Litigation management experience
  • Experience working within a TPA environment
  • Bilingual (English/Spanish) is a bonus

Why You'll Love Working Here
  • 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
  • Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
  • Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
  • Career growth: Internal training and advancement opportunities
  • Culture: A supportive, team-based work environment

How We Measure Success
At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:
  • Quality claim handling - thorough investigations, strong documentation, well-supported decisions
  • Compliance & audit performance - adherence to jurisdictional and client standards
  • Timeliness & accuracy - purposeful file movement and dependable execution
  • Client partnership - proactive communication and strong follow-through
  • Professional judgment - owning outcomes and solving problems with integrity
  • Cultural alignment - believing every claim represents a real person and acting accordingly

This is where we shine, and we hire adjusters who want to shine with us.
Compensation & Compliance
The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.
CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance.
Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.
Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.
ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.
Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.
Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.
Our Core Values
At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who:
  • Lead with transparency We build trust by being open and listening intently in every interaction.
  • Perform with integrity We choose the right path, even when it is hard.
  • Chase excellence We set the bar high and measure our success. What gets measured gets done.
  • Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
  • Win together Our greatest victories come when our clients succeed.

We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.
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