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Remote Risk Adjustment Coder Jobs in Rancho Cordova, CA

Dignity Health Medical Group

QCDI Coder

Rancho Cordova, CA · Remote

$32.38 - $48.17/hr

As a remote employee, we will provide you with the equipment needed to work from home, including a ... HCC, risk adjustment, or specialty coding experience preferred * Experience with MSSP preferred

CommonSpirit Health

QCDI Coder

Rancho Cordova, CA · Remote

$20 - $26.75/hr

As a remote employee, we will provide you with the equipment needed to work from home, including a ... HCC, risk adjustment, or specialty coding experience preferred * Experience with MSSP preferred

Posted today

Adventist Health

Sr. Certified Coder (Remote)

Roseville, CA · On-site +1

$23.75 - $31.75/hr

Reviews patient records to identify the diagnosis and procedure codes performed during the patients stay are valid and in accordance with coding conventions and guidelines. Applies substantial ...

Adventist Health

Sr. Certified Coder (Remote)

Roseville, CA · On-site +1

$30.79 - $46.15/hr

Reviews patient records to identify the diagnosis and procedure codes performed during the patients stay are valid and in accordance with coding conventions and guidelines. Applies substantial ...

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Remote Risk Adjustment Coder information

See Rancho Cordova, CA salary details

$16

$29

$46

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

As of Sep 2, 2026, the average hourly pay for remote risk adjustment coder in Rancho Cordova, CA is $29.33, according to ZipRecruiter salary data. Most workers in this role earn between $20.24 and $36.92 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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QCDI Coder

Dignity Health Medical Group

Rancho Cordova, CA • Remote

$32.38 - $48.17/hr

Full-time

Posted 8 days ago

Dignity Health rating

7.9

Company rating: 7.9 out of 10

Based on 285 frontline employees who took The Breakroom Quiz

109th of 898 rated healthcare providers

Job description


Job Summary and Responsibilities

As our Quality Clinical Documentation Improvement (QCDI) Coding Specialist, your primary focus will be to facilitate and ensure the comprehensive capture of billing data for the purpose of accurately reporting HCC's, participating in the reconciliation of patient medical and billing records, and identifying reimbursement/quality of care opportunities. Additionally this role will provide provider education and review trends of assigned provider or medical groups.  The Hierarchical Condition Category (HCC) Quality Program was developed by CMS to promote quality care for Medicare Advantage members. By focusing on comprehensive documentation to identify, evaluate and assess chronic conditions at the appropriate specificity, patient medical needs are met at the highest level.
Every day you will perform comprehensive chart reviews to ensure documentation required to facilitate the reporting of HCC diagnoses to payer.  You will also identify claims correction opportunities and submit to appropriate personnel for processing.
To be successful in this role, you will have an extensive knowledge of payer contract guidelines, a strong background in coding, and a high level of attention to detail.
As a remote employee, we will provide you with the equipment needed to work from home, including a laptop, docking station, dual monitors, and accessories.


This position is work from home for residents of CA.

  • Performs comprehensive chart reviews to ensure documentation required to facilitate the reporting of HCC diagnoses to payer
  • Identifies claims correction opportunities and submits to appropriate personnel for processing
  • Demonstrates analytical and problem-solving ability regarding review of submitted diagnosis codes versus services reflected in the documentation in the patient's chart note
  • Follows department policies and guidelines on appropriate documentation to billing codes, abstracting information from chart notes based on performance program measures
  • Partners with QCDI Nurse, as necessary, to identify trends and gaps for creating better process efficiency and provider performance
  • Assists in the development and reporting of HCC and Pay for Performance Metrics
Job Requirements
Required
  • 5 years experience as a clinic coder
  • Extensive knowledge of payer contract guidelines
  • Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
  • Analytical and problem solving skills with the ability to understand clinical compliance guidelines, complex reimbursement structures and to apply contractual and governmental regulations to internal processes. Superior organizational skills. Superior written and verbal communication skills. Able to work with minimum daily supervision.

Preferred
  • Bachelors degree or equivalent work experience preferred
  • HCC, risk adjustment, or specialty coding experience preferred
  • Experience with MSSP preferred
  • Technical/software acumen preferred
Where You'll Work

Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service.

Qualifications:
Required
  • 5 years experience as a clinic coder
  • Extensive knowledge of payer contract guidelines
  • Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
  • Analytical and problem solving skills with the ability to understand clinical compliance guidelines, complex reimbursement structures and to apply contractual and governmental regulations to internal processes. Superior organizational skills. Superior written and verbal communication skills. Able to work with minimum daily supervision.

Preferred
  • Bachelors degree or equivalent work experience preferred
  • HCC, risk adjustment, or specialty coding experience preferred
  • Experience with MSSP preferred
  • Technical/software acumen preferred
Employment Type: Full Time

What Dignity Health employees say

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Benefits

Hours and flexibility

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About Dignity Health

Sourced by ZipRecruiter

We welcome the chance to help you feel your best. Excellent, affordable health care, delivered with compassion, is what we stand for. Since our founding in 1986, we've made it our goal to create environments that meet each patient's physical, mental, and spiritual needs. We also believe this healing philosophy promotes the wellbeing of our staff and the places they serve. Dignity Health is made up of more than 60,000 caregivers and staff who deliver excellent care to diverse communities in 21 states. Headquartered in San Francisco, Dignity Health is the fifth largest health system in the nation and the largest hospital provider in California. Through teamwork and innovation, faith and compassion, advocacy and action, we endeavor every day to keep you happy, healthy, and whole.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

San Francisco, CA, US

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