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Remote Risk Adjustment Coder Jobs in Tobyhanna, PA

BillionToOne

Account Executive

Scranton, PA · Remote

$184.57K - $248.27K/yr

Responsibilities: * Increasing utilization of UNITY Fetal Risk Screen and driving market ... Demonstrated values and ethics that support BillionToOne's mission, goals, and professional code of ...

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All JobsRemote Risk Adjustment Coder JobsRemote Risk Adjustment Coder Jobs in Tobyhanna, PA

Remote Risk Adjustment Coder information

See Tobyhanna, PA salary details

$15

$26

$42

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

As of Jun 1, 2026, the average hourly pay for remote risk adjustment coder in Tobyhanna, PA is $26.55, according to ZipRecruiter salary data. Most workers in this role earn between $18.32 and $33.41 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 Tobyhanna, PA? For Remote Risk Adjustment Coder jobs in Tobyhanna, PA, the most frequently searched job titles are:
What cities near Tobyhanna, PA are hiring for Remote Risk Adjustment Coder jobs? Cities near Tobyhanna, PA with the most Remote Risk Adjustment Coder job openings:
Remote Risk Adjustment Coder jobs near you
Specialist, Payment and Accounts Receivable

Specialist, Payment and Accounts Receivable

The Wright Center for Graduate Medical Education

Scranton, PA • On-site, Remote

$18.50 - $22.75/hr

Other

Posted 13 days ago

The Wright Center rating

7.8

Company rating: 7.8 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

Job description

Description

POSITION SUMMARY

The Payment & Accounts Receivable Specialist provides financial, administrative and clerical services to ensure accuracy and efficiency of billing operations. This position performs payment posting, insurance denial posting and AR follow up, insurance submission, patient refund preparation, prepares deposits and other AR tasks.
 

Work is typically performed in an office environment, but this position has the option to work from home but may also be needed onsite for projects or team meetings from time to time. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements for this job description are not intended to be all inclusive. They represent typical elements considered necessary to successfully perform the job. 


REPORTING RELATIONSHIPS

The position reports to the Director of Revenue Cycle. No staff report to this position.


ESSENTIAL JOB DUTIES and FUNCTIONS

While living and demonstrating our Core Values, the Payment & Accounts Receivable Specialist will:

  • Post all mail and EFT insurance and personal payments to patient's accounts
  • Post denials to patient accounts and follow up with payer
  • Transfer copay/co-insurance and deductible balances to patient responsibility
  • Reconciliation of daily deposits
  • Perform remote bank deposit for checks received in the mail
  • Knowledge of EOB's, EFT's and ERA's
  • Analyze EOB's, balance healthcare insurance and patient payments
  • Perform adjustments and credits to medical accounts as needed
  • Follow up on outstanding accounts receivable, focusing on maintaining aged receivables within 90 days of days outstanding. Includes researching aged account reports, outstanding "to-do" list, and processing problematic EOB's
  • Make all necessary corrections in the billing system. Research and resolve claims rejected by payer
  • Use online Healthcare databases and other resources for verification and claim status
  • Deliver the highest quality medical customer service to healthcare providers and internal providers
  • Assist other members of the team with other projects as needed
  • Research outstanding credit balances and prepare requests for refunds 
  • Other duties as assigned by management

Requirements

QUALIFICATIONS

  • Meet The Wright Center for Community Health and its affiliated entity The Wright Center for Graduate Medical Education EOS People Analyzer Tool
  • Buy in and experience working in the EOS model (strongly preferred)
  • Mission-oriented; represents the enterprise in a professional manner while demonstrating organizational pride
  • High school degree or equivalent 
  • 1 - 3 years medical billing/claims experience
  • Knowledge of EOBs, EFTs and ERAs
  • Experience in CPT codes and ICD 10 coding preferred 
  • Experience with electronic medical records preferred
  • FQHC billing and payment posting preferred, but will train the right candidate
  • Medent experience preferred 
  • Knowledge of Microsoft Office software
  • Must be focused, self-directed, organized, and have demonstrated problem-solving abilities
  • Accurate and precise attention to detail
  • Excellent verbal and written communication skills
  • Able to work both independently and as part of a team

Apply