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Remote Risk Adjustment Coding Jobs in California

sdaihc

Finance_Certified_Coder

San Diego, CA · Remote

$24 - $32.75/hr

Active coding certification required: CPC (Certified Professional Coder, AAPC) or CCS (Certified Coding Specialist, AHIMA); CRC (Certified Risk Adjustment Coder) a plus. * Minimum two (2) to three ...

sdaihc

Finance_Certified_Coder

San Diego, CA · Remote

$24 - $32.75/hr

Active coding certification required: CPC (Certified Professional Coder, AAPC) or CCS (Certified Coding Specialist, AHIMA); CRC (Certified Risk Adjustment Coder) a plus. * Minimum two (2) to three ...

Urrly

Telehealth Nurse Practitioner

Los Angeles, CA · Remote

$600 - $720/day

Document HCC (risk adjustment) during visits * Close HEDIS (quality measures) care gaps * Review ... Code with ICD-10 and CPT II * Deliver care plans and follow-up * Keep clean, audit-ready ...

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Remote Risk Adjustment Coding information

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$23

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

As of Jul 21, 2026, the average hourly pay for remote risk adjustment coding in California is $21.22, according to ZipRecruiter salary data. Most workers in this role earn between $17.79 and $22.55 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 medical coding, anatomy, and healthcare regulations, typically backed by a coding certification such as CPC, CRC, or CCS. Familiarity with coding software, electronic health record (EHR) systems, and risk adjustment models like HCC is essential. Attention to detail, critical thinking, and strong written communication are crucial soft skills for interpreting clinical documentation and ensuring coding accuracy. These skills and qualifications are vital to accurately capture patient risk, ensure compliance, and optimize reimbursement for healthcare organizations.

What is remote risk adjustment coding?

Remote risk adjustment coding is the process of reviewing and assigning medical codes to patient diagnoses and procedures from a remote location, usually at home. The purpose is to ensure that healthcare organizations accurately report the health status of their patients, which affects reimbursement from health plans. Coders use specialized knowledge of ICD-10-CM coding and risk adjustment models, such as HCC (Hierarchical Condition Category) coding, to capture all relevant chronic conditions. This position requires attention to detail, compliance with regulations, and strong analytical skills.

What is the difference between Remote Risk Adjustment Coding vs Remote Medical Coding?

AspectRemote Risk Adjustment CodingRemote Medical Coding
CertificationsRHIA, RHIT, CPC, CCSCPC, CCS, CCS-P
Work EnvironmentHealthcare organizations, insurance companiesHospitals, clinics, insurance companies
Industry UsageHealth insurance, risk adjustment programsMedical billing, claims processing

Remote Risk Adjustment Coding focuses on analyzing patient data for insurance risk assessments, requiring specific risk adjustment certifications. Remote Medical Coding involves coding diagnoses and procedures for billing purposes. While both roles require coding certifications, Risk Adjustment Coding emphasizes risk analysis within insurance, whereas Medical Coding centers on billing accuracy.

How does working remotely as a Risk Adjustment Coder impact collaboration with healthcare teams and ongoing professional development?

As a remote Risk Adjustment Coder, you'll often collaborate with clinical staff, auditors, and other coders through secure digital platforms and regular virtual meetings. While remote work offers flexibility, it also means that proactive communication is essential to ensure accurate coding and compliance with regulations. Many organizations provide virtual training sessions, access to coding forums, and ongoing education to help you stay updated on industry changes and coding standards. Building relationships with your team and participating in online professional communities can further support your growth and help overcome the isolation that sometimes comes with remote work.
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What cities in California are hiring for Remote Risk Adjustment Coding jobs? Cities in California with the most Remote Risk Adjustment Coding job openings:
Remote Risk Adjustment Coding jobs near you
Infographic showing various Remote Risk Adjustment Coding job openings in California as of July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, and 7% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $44,138 per year, or $21.2 per hour.
Risk & Quality Performance Manager (Remote)

Risk & Quality Performance Manager (Remote)

Molina Healthcare

Long Beach, CA • Remote

Full-time

Re-posted yesterday

Molina Healthcare rating

8.1

Company rating: 8.1 out of 10

Based on 193 frontline employees who took The Breakroom Quiz

133rd of 281 rated insurance

Job description

Job Description


Job Summary

The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage resources and execute performance improvement initiatives in alignment with RQS's strategic objectives.

Job Duties

 Collaborate with Health Plan Risk and Quality leaders to improve outcomes by managing Risk/Quality data collection strategy, analytics, and reporting, including but not limited to: Risk/Quality rate trending and forecasting; provider Risk/Quality measure performance, CAHPS and survey analytics, health equity and SDOH, and engaging external vendors. 
 Monitor projects from inception through successful delivery.
 Oversee Risk/Quality data ingestion activities and strategies to optimize completeness and accuracy of EHR/HIE and supplemental data.
 Meet customer expectations and requirements, establish, and maintain effective relationships and gain their trust and respect.
 Draw actionable conclusions, and make decisions as needed while collaborating with other teams.
 Ensure compliance with all regulatory audit guidelines by adhering to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success.
 Partner with other teams to ensure data quality through sequential transformations and identify opportunities to close quality and risk care gaps.
 Proactively communicate risks and issues to stakeholders and leadership.
 Create, review, and approve program documentation, including plans, reports, and records.
 Ensure documentation is updated and accessible to relevant parties.
 Proactively communicate regular status reports to stakeholders, highlighting progress, risks, and issues.

Job Qualifications

REQUIRED EDUCATION:

Bachelor's degree or equivalent combination of education and experience

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

2+ years of program and/or project management experience in risk adjustment and/or quality
 2+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems
 2+ years of data analysis experience utilizing technical skillsets and resources to answer nuanced Risk and Quality questions posed from internal and external partners
 Familiarity with running queries in Microsoft Azure or SQL server
 Healthcare experience and functional risk adjustment and/or quality knowledge
 Mastery of Microsoft Office Suite including Excel and Project
 Experience partnering with various levels of leadership across complex organizations
 Strong quantitative aptitude and problem solving skills
 Intellectual agility and ability to simplify and clearly communicate complex concepts
 Excellent verbal, written and presentation capabilities
 Energetic and collaborative

PREFERRED EDUCATION:

Graduate degree or equivalent combination of education and experience

PREFERRED EXPERIENCE:

 Knowledge of, and familiarity with, NCQA, CMS, and State regulatory submission requirements
 Experience working in a cross-functional, highly matrixed organization
 SQL proficiency
 Knowledge of healthcare claim elements: CPT, CPTII, LOINC, SNOMED, HCPS, NDC, CVX, NPIs, TINs, etc.
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification, and/or comparable coursework desired

#PJCorp

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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