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Remote Risk Adjustment Coder Jobs in Simpsonville, SC

Ascension

Coding Manager

Taylors, SC · Remote

$85.60K - $115K/yr

Remote / Periodic travel to WI Corporate Office. Department/Specialty: Coding Schedule: Full-time / 7am - 7pm - Monday through Friday (Varying hours to meet the requirements of the role). Salary ...

Ascension

Coding Manager

Taylors, SC · Remote

$85.67K/yr

Remote / Periodic travel to WI Corporate Office. Department/Specialty: Coding Schedule: Full-time / 7am - 7pm - Monday through Friday (Varying hours to meet the requirements of the role). Salary ...

FabLogix

Mechanical 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 ...

Mullins Mechanical

Mechanical 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 ...

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

As of May 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 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, 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 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 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.

More about Remote Risk Adjustment Coder jobs
What are popular job titles related to Remote Risk Adjustment Coder jobs in Simpsonville, SC? For Remote Risk Adjustment Coder jobs in Simpsonville, SC, the most frequently searched job titles are:
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 May 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $50,679 per year, or $24.4 per hour.
Ambulatory Coder II Professional Billing, FT, Days, - Remote

Ambulatory Coder II Professional Billing, FT, Days, - Remote

Prisma Health

Greenville, SC • Remote

Full-time

Posted 20 days ago

Prisma Health rating

7.0

Company rating: 7.0 out of 10

Based on 333 frontline employees who took The Breakroom Quiz

401st of 864 rated healthcare providers

Job description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Responsible for validating/reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s). Communicates with providers and team members regarding coding issues.

Essential Functions

  • All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion.Be the difference.

  • Validates/reviews codes for assigned provider(s)/Division(s) based on medical record documentation. Adheres to all coding and compliance guidelines.

  • Responsible for resolving all assigned pre-billing edits

  • Communicates billing related issues and participates in meetings to improve overall billing process

  • Provides feedback to providers in order to clarify and resolve coding concerns.

  • Assists in identifying areas that need additional training.

  • 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 - Two (2) years professional coding experience

In Lieu Of

  • NA

Required Certifications, Registrations, Licenses

  • Certified Professional Coder-CPC

Knowledge, Skills and Abilities

  • Maintains knowledge of governmental and commercial payer guidelines.

  • Participates in coding educational opportunities (webinars, in house training, etc.).

  • Ability to utilizes appropriate coding software and coding resources in order to determine correct codes.

  • Proficient computer skills including word processing, spreadsheets, database

  • Data entry skills

  • Mathematical skills

Work Shift

Day (United States of America)

Location

Independence Pointe

Facility

7001 Corporate

Department

70019178 Medical Group Coding & Education 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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