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Remote Risk Adjustment Coding Jobs in Maine (NOW HIRING)

NinjaOne

Location - We are flexible on remote working from home, if you are located in the USA and reside in ... Provide subject matter expertise in code reviews, integration, and deployment events. Lead the ...

NinjaOne

Providing clean and optimized coding solutions, you'll work to develop high-quality software ... Location - We are flexible on remote working from home, if you are located in the USA and reside in ...

NinjaOne

Location - We are flexible on remote working from home, if you are located in the USA and reside in ... code. * Proven ability to take product features from idea to delivery and iterate based on customer ...

NinjaOne

Location - We are flexible on remote working from home, if you are located in the USA and reside in ... Experience with cloud automation and infrastructure-as-code (IaC) toolsets, primarily ...

All JobsRisk Adjustment Coding JobsRemote Risk Adjustment Coding JobsRemote Risk Adjustment Coding Jobs in Maine

Remote Risk Adjustment Coding information

See Maine salary details

$16

$20

$23

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

As of Jul 18, 2026, the average hourly pay for remote risk adjustment coding in Maine is $20.82, according to ZipRecruiter salary data. Most workers in this role earn between $17.45 and $22.12 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.
What are popular job titles related to Remote Risk Adjustment Coding jobs in Maine? For Remote Risk Adjustment Coding jobs in Maine, the most frequently searched job titles are:
What job categories do people searching Remote Risk Adjustment Coding jobs in Maine look for? The top searched job categories for Remote Risk Adjustment Coding jobs in Maine are:
What cities in Maine are hiring for Remote Risk Adjustment Coding jobs? Cities in Maine 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 Maine as of July 2026, with employment types broken down into 1% As Needed, 75% Full Time, 17% Part Time, and 7% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $43,301 per year, or $20.8 per hour.
REMOTE - Vice President Medical Director of Clinical Programs

REMOTE - Vice President Medical Director of Clinical Programs

Martin's Point Health Care

Portland, ME • On-site, Remote

Full-time

Medical, Vision

Posted 11 days ago

Martin’s Point Health Care rating

7.4

Company rating: 7.4 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

Job description

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.
Position Summary
The Vice President, Medical Director, Health Plan provides senior clinical leadership across the Health Plan, with a focus on quality, affordability, compliance, clinical performance, and member outcomes. This role requires strong health plan experience, the ability to lead across functions, and the communication skills to influence clinical, operational, financial, regulatory, and executive stakeholders.
Job Description
Employees are expected to support and demonstrate the mission, vision, and core values of Martin's Point Health Care.
Key responsibilities include:
  • Partner with Health Plan senior leadership to advance clinical outcomes, affordability goals, growth targets, and overall health plan strategy.
  • Provide clinical leadership across utilization management, care management, population health, quality, pharmacy, medical policy, payment policy, and clinical program development.
  • Lead cross-functional collaboration among Medical Directors, Medical Economics, Quality, Network, Compliance, Pharmacy, Operations, and Clinical Programs.
  • Support compliance with government program requirements, including clinical appeals and grievances, using sound clinical evidence and medical judgment.
  • Use clinical, quality, utilization, and financial data to identify trends, assess performance, and recommend actionable interventions.
  • Develop strategies to improve medical expense management, appropriate utilization, quality of care, and population health outcomes.
  • Provide clinical input into product design, Medicare bids, risk adjustment, STARS, HEDIS, value-based arrangements, and clinical integration initiatives.
  • Communicate complex clinical, regulatory, and operational information clearly to executive, provider, clinical, and non-clinical audiences.
  • Support appropriate utilization of services through strong partnership with Utilization Management, Care Management, and physician leaders.
  • Represent the organization with regulatory entities, professional societies, providers, network partners, and external stakeholders, as appropriate.
  • Build and strengthen relationships with hospitals, physicians, and other health care providers to support network engagement and performance goals.
  • Support strategies tied to population health, care management, provider performance, and contractual outcomes.
  • Lead, support, and develop physician leaders and clinical team members, as assigned.
Position Qualifications
Required
  • Medical Degree, MD or DO, from an accredited medical school.
  • Board certification in a relevant medical discipline or specialty.
  • Active, unrestricted medical license, or ability to obtain licensure in a state relevant to the role.
  • Ten or more years of professional experience, including clinical practice experience.
  • Health plan, managed care, or payer experience in a Medical Director or comparable physician leadership role.
  • Demonstrated experience working across health plan functions, such as utilization management, care management, quality, appeals and grievances, population health, medical economics, provider relations, pharmacy, compliance, or network.
  • Experience using clinical, quality, utilization, or financial data to guide decisions, develop interventions, and measure outcomes.
  • Strong cross-functional leadership skills, with the ability to align clinical, operational, financial, and regulatory priorities.
  • Strong verbal, written, and presentation skills, including the ability to communicate effectively with executive, clinical, provider, operational, and regulatory audiences.
  • Ability to influence, collaborate, and build credibility with internal and external stakeholders.
  • Strong analytical, problem-solving, and decision-making skills.
  • Demonstrated alignment with Martin's Point Health Care values.
Preferred
  • Experience with Medicare Advantage, TRICARE, or other government-sponsored programs.
  • Experience with STARS, RAF, risk adjustment, Medicare bids, HEDIS, or value-based care arrangements.
  • Prior management or physician leadership experience.
  • Experience supporting medical policy, payment policy, pharmacy, or clinical program development.
  • Experience building relationships with network physicians, hospitals, and community providers.

This position is not eligible for immigration sponsorship.
We are an equal opportunity/affirmative action employer.
Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact jobinquiries@martinspoint.org
Do you have a question about careers at Martin's Point Health Care? Contact us at: jobinquiries@martinspoint.org

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