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Remote Risk Adjustment Coder Jobs (NOW HIRING)

HealthEdge

Director, Risk Adjustment Products

Work with various departments, including revenue management, coding, and compliance, to align ... Remote - US Travel required for client sessions, workshops, and internal collaboration. HealthEdge ...

Altegra Health

Remote Certified Coder

Atlantic City, NJ · Remote

$22.50 - $31/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and ...

Altegra Health

Remote Certified Coder

Dallas, TX · Remote

$22.25 - $30.50/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and ...

Altegra Health

Remote Certified Coder

Atlantic City, NJ · On-site +1

$22.50 - $31/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and ...

Altegra Health

Remote Certified Coder

Dallas, TX · On-site +1

$22.25 - $30.50/hr

Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ... Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and ...

Humana

Medical Coder

Jacksonville, NC · On-site +1

$17 - $22.50/hr

Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Medical Coder

Florence, SC · On-site +1

$18.25 - $24.25/hr

Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Medical Coder

Huntersville, NC · On-site +1

$17.50 - $23.50/hr

Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Medical Coder

Mount Crawford, VA · On-site +1

$17.75 - $23.75/hr

Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Medical Coder

Colonial Beach, VA · On-site +1

$19 - $25.25/hr

Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

$19.25 - $25.50/hr

Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Medical Coder

Alexandria, VA · On-site +1

$20 - $26.75/hr

Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

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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 Jun 14, 2026, the average hourly pay for remote risk adjustment coder in the United States is $27.49, according to ZipRecruiter salary data. Most workers in this role earn between $18.99 and $34.62 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
What cities are hiring for Remote Risk Adjustment Coder jobs? Cities with the most Remote Risk Adjustment Coder job openings:
What are the most commonly searched types of Risk Adjustment Coder jobs? The most popular types of Risk Adjustment Coder jobs are:
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Remote Risk Adjustment Coder jobs near you
Infographic showing various Remote Risk Adjustment Coder job openings in the United States as of June 2026, with employment types broken down into 79% Full Time, and 21% Contract. Highlights an 100% Remote job distribution, with an average salary of $57,182 per year, or $27.5 per hour.
Informatics Risk Adjustment Consultant

Informatics Risk Adjustment Consultant

HealthPartners

Saint Paul, MN • On-site, Remote

$63.77 - $95.65/hr

Full-time

Medical, Retirement

Posted 5 days ago

HealthPartners rating

7.8

Company rating: 7.8 out of 10

Based on 128 frontline employees who took The Breakroom Quiz

130th of 872 rated healthcare providers

Job description

Job Description
HealthPartners is hiring a Informatics Risk Adjustment Consultant. The Informatics Consultant -supports the Health Plan's risk adjustment operations by delivering trusted, prioritized, and compliant data insights that drive efficient workflows and improve risk score accuracy, while continuously refining processes through feedback. This role ensures the plan's risk adjustment outputs are accurately represented in claims and encounter data, analytics, and reporting.
The consultant serves as a bridge between the data/technology teams and risk adjustment operations, clinical/provider stakeholders, coding and chart review teams, and compliance/audit partners. The role enables informed, compliant, and actionable risk adjustment program, while maintaining strong governance, audit readiness, and organizational standards.
ACCOUNTABILITIES:
Risk Adjustment Strategy & Program Execution
  • Support planning and execution of annual risk adjustment initiatives (prospective, concurrent, and retrospective), aligned to plan goals and regulatory requirements.
  • Translate risk adjustment priorities into practical workflows, playbooks, and measurable interventions across provider groups and vendor partners.
  • Partner with risk adjustment operations to optimize data capture, risk score modeling, member stratifications, suspecting logic, and program outcomes.

Diagnosis Accuracy, Clinical Validity & Documentation Integrity
  • Identify patterns of under-capture, over-capture, and potential diagnosis coding inaccuracies; drive suspecting logic and workflow improvements.
  • Support provider-facing reporting

Encounter & Claims Data Quality (Core Health Plan Focus)
  • Work with operational and technical teams to improve completeness, timeliness, and accuracy of encounter data and diagnosis submission (including resolving rejections, edit failures, and submission gaps).
  • Define and monitor data quality KPIs (e.g., encounter internal validations, submission rates, acceptance rates, diagnosis completeness, provider group variation, lag time).

Provider & Vendor Enablement (External-Facing Consulting)
  • Support relationships with provider groups, delegated entities, and vendor partners to improve data exchange and workflows
  • Participate in vendor management activities (requirements gathering, performance monitoring, issue escalation, and continuous improvement).

Measurement, Analytics & Performance Reporting
  • Define and track risk adjustment performance measures such as:
    • Reconfirmation rates and suspected-condition confirmation rates
    • Member visit rates and provider engagement
    • Condition prevalence shifts and variation analysis
    • Net risk score movement (where appropriate) with integrity guardrails, and drivers of risk
    • Encounter submission acceptance rates
    • Audit results and feedback loop reporting
  • Partner with analytics teams to develop dashboards and actionable reporting (e.g., Power BI), and to ensure consistent measure definitions.

Compliance, Audit Readiness & Governance
  • Partner with compliance, internal audit, and risk adjustment leadership to support audit readiness (e.g., documentation standards, monitoring, validation processes).
  • Help implement controls and monitoring to identify outliers and reduce risk (e.g., unusual provider patterns, unsupported diagnoses, excessive suspecting false positives).
  • Maintain familiarity with current risk adjustment policies and guidance, and support operational implementation of updates.

Cross-Functional Leadership & Change Management
  • Facilitate collaboration between data/technology teams and risk adjustment operations, clinical/provider stakeholders, coding and chart review teams, and compliance/audit partners.
  • When asked, co-lead small to medium initiatives end-to-end, including requirements definition, workflow design, stakeholder engagement, training, measurement, and sustainment.
    REQUIRED QUALIFICATIONS:

1. Education
  • Bachelor's degree in health informatics, nursing, health information management, public health, business, or related field; or equivalent combination of education and experience.

2. Experience and Knowledge
  • 5+ years of experience in health plan and/or risk adjustment-related domains, such as: risk adjustment operations, encounter data management, coding, clinical documentation integrity, provider performance, quality improvement, or healthcare analytics.
  • Working knowledge of how diagnoses flow through EHR → coding/chart review → encounter/claims submission → risk adjustment analytics.
  • Experience collaborating with provider organizations and/or delegated entities to improve documentation and data submission practices.
  • Experience using data to drive improvement: ability to interpret trends, variation, root cause issues, and performance metrics.
  • Familiarity with Medicare Advantage (preferred) and/or other risk programs, including chart review concepts and audit sensitivity.

3. Skills
  • Strong consulting, facilitation, and stakeholder management skills; able to influence without authority.
  • Excellent written and verbal communication; able to create clear playbooks, training, and executive-ready summaries.
  • Strong analytical thinking and operational problem-solving; comfortable navigating ambiguous issues across workflows and systems.
  • High integrity and sound judgment; commitment to compliant, clinically appropriate documentation practices.
  • Strong project management skills; ability to manage multiple workstreams, deadlines, and cross-functional dependencies.

PREFERRED QUALIFICATIONS:
  • Credentials such as CRC, CPC, CCS, CDIP, CCDS (or comparable).
  • Experience working directly with MA encounter submission processes, edit resolution, or encounter data ingestion/validation.
  • Experience supporting chart retrieval/coding vendors and performance management (KPIs, SLAs, escalation paths).
  • Familiarity with audit processes and documentation standards (e.g., retrospective validation, risk adjustment audits), and designing monitoring/controls.
  • Experience developing or specifying requirements for dashboards and operational reporting (Power BI, Tableau, or equivalent).
  • Solid working experience with SQL and relational database design
  • Exposure to agile/scrum
  • Experience using Azure suite of tools, Databricks, Azure Data Lake
  • Experience in a highly regulated environment and comfort partnering closely with compliance and privacy.

About Us
At HealthPartners we believe in the power of good - good deeds and good people working together. As part of our team, you'll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work.
We're a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improve lives around the world.
At HealthPartners, everyone is welcome, included and valued. We're working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.
Benefits Designed to Support Your Total HealthAs a HealthPartners colleague, we're committed to nurturing your diverse talents, valuing your dedication, and supporting your work-life balance. We offer a comprehensive range of benefits to support every aspect of your life, including health, time off, retirement planning, and continuous learning opportunities. Our goal is to help you thrive physically, mentally, emotionally, and financially, so you can continue delivering exceptional care.
Join us in our mission to improve the health and well-being of our patients, members, and communities.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant because of race, color, sex, age, national origin, religion, sexual orientation, gender identify, status as a veteran and basis of disability or any other federal, state or local protected class.

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