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Remote Risk Adjustment Coder Jobs in Simpsonville, SC

FabLogix

Estimator

Duncan, SC · On-site +1

Duncan, SC or open to Hybrid remote Job Type: Full-time Job Summary: We are seeking an experienced ... Ensure compliance with industry standards, codes, and safety regulations * Identify project risks ...

DPR Construction

HR Technology Leader

Greenville, SC · On-site +1

This role is remote and open to candidates in the continental United States. This role requires ... Coordinate with Risk Management to review contracts and their terms & conditions and service level ...

AECOM

Electrical Discipline Lead

Greenville, SC · On-site +1

$150K - $157K/yr

Provides technical expertise for risk assessments, due diligence and other studies presenting ... in remote and multi-discipline teams * Expert familiarity with industry codes and standards (IBC ...

All JobsRisk Adjustment Coder JobsRemote Risk Adjustment Coder JobsRemote Risk Adjustment Coder Jobs in Simpsonville, SC

Remote Risk Adjustment Coder information

See Simpsonville, SC salary details

$14

$24

$38

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

As of Jul 31, 2026, the average hourly pay for remote risk adjustment coder in Simpsonville, SC is $24.36, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $30.67 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
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What job categories do people searching Remote Risk Adjustment Coder jobs in Simpsonville, SC look for? The top searched job categories for Remote Risk Adjustment Coder jobs in Simpsonville, SC are:
What cities near Simpsonville, SC are hiring for Remote Risk Adjustment Coder jobs? Cities near Simpsonville, SC 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 Simpsonville, SC as of July 2026, with employment types broken down into 1% As Needed, 76% Full Time, 16% Part Time, and 7% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $50,679 per year, or $24.4 per hour.

Risk Adjustment Coder Professional Billing II, FT, Days, - Remote

Prisma Health

Greenville, SC • On-site, Remote

Full-time

Posted 15 days ago

Prisma Health rating

7.1

Company rating: 7.1 out of 10

Based on 348 frontline employees who took The Breakroom Quiz

376th of 885 rated healthcare providers

Job description

Inspire health. Serve with compassion. Be the difference.
Job Summary
Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission.
Essential Functions
  • All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.
  • Conducts prospective review of charts to identify HCC opportunity.
  • Conducts retrospective review of charts to confirm documentation supports reporting.
  • Utilizes payor specific software to assist in capturing HCCs.
  • Communicates with providers about HCC opportunities for improvement.
  • Identifies suspect conditions that would potentially support reporting an HCC.
  • Participates in education offerings
  • Participates in monthly meetings
  • Performs other duties as assigned.

Supervisory/Management Responsibilities
  • This is a non-management job that will report to a supervisor, manager, director or executive.

Minimum Requirements
  • Education - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred
  • Experience - Five (5) years professional fee coding experience

In Lieu Of
  • NA

Required Certifications, Registrations, Licenses
  • Certified Professional Coder (CPC), and
  • Certified Risk Adjustment Coder (CRC)

Knowledge, Skills and Abilities
  • Knowledge of office equipment (fax/copier)
  • Proficient computer skills including word processing, spreadsheets, database
  • Data entry skills
  • Mathematical skills

Work Shift
Day (United States of America)
Location
Patewood Memorial Hospital
Facility
7002 Value-Based Care and Network Services
Department
70028459 HCC Coding Services
Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

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