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Remote Risk Adjustment Coding Jobs in Ohio (NOW HIRING)

CareSource

Applied AI Scientist III

Dayton, OH · On-site +1

... expertise and code reviews. Essential Functions: * Evaluate emerging technology in LLMs, NLP ... Work closely with interdisciplinary teams across IT, risk adjustment, program integrity, HEDIS ...

Quadax, Inc.

Receipt Poster

Cleveland, OH · On-site +1

$18 - $20/hr

Although this position is listed as remote, the new team member will be required to complete 5 days ... Post contracted and negotiated adjustments when applicable. * Determine the cause of credit ...

Signet Jewelers Ltd.

Xstore Developer (Remote)

Akron, OH · On-site +1

$74K - $125K/yr

Dallas, TX or Akron, OH (Hybrid) Preferred Open to remote POSITION SUMMARY : The Developer is ... Participate in technical walkthroughs and code reviews. * Migrate complex, high-risk solutions into ...

Signet Jewelers Ltd.

Xstore Developer (Remote)

Akron, OH · On-site +1

$74K - $125K/yr

Dallas, TX or Akron, OH (Hybrid) Preferred Open to remote POSITION SUMMARY : The Developer is ... Participate in technical walkthroughs and code reviews. * Migrate complex, high-risk solutions into ...

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Remote Risk Adjustment Coding information

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

As of Jul 14, 2026, the average hourly pay for remote risk adjustment coding in Ohio is $20.44, according to ZipRecruiter salary data. Most workers in this role earn between $17.16 and $21.73 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 Ohio? For Remote Risk Adjustment Coding jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Remote Risk Adjustment Coding jobs in Ohio look for? The top searched job categories for Remote Risk Adjustment Coding jobs in Ohio are:
What cities in Ohio are hiring for Remote Risk Adjustment Coding jobs? Cities in Ohio 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 Ohio as of July 2026, with employment types broken down into 1% As Needed, 77% Full Time, 16% Part Time, and 6% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $42,519 per year, or $20.4 per hour.
Quality Risk Adjustment Advisor IV (Health Plan experience required)

Quality Risk Adjustment Advisor IV (Health Plan experience required)

CareSource

Dayton, OH • On-site, Remote

$83K - $132K/yr

Full-time

Posted 19 days ago

CareSource rating

7.7

Company rating: 7.7 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

183rd of 281 rated insurance

Job description

Job Summary:
The Quality Risk Adjustment Advisor IV is responsible for leading key components of the Quality Risk Adjustment (QRA) programs, including prospective programs, chart retrieval and coding processes, while ensuring compliance with regulatory standards and optimizing quality outcomes. This role partners closely with internal stakeholders and external vendors to enhance operational effectiveness and leverage artificial intelligence (AI) technologies to improve data accuracy, efficiency, and overall program performance.
Essential Functions:
  • Serve as a subject matter expert in Risk Adjustment operations, supporting prospective programs, chart retrieval and coding processes.
  • Identify and recommend strategies to optimize risk adjustment processes and improve quality metrics across insourced and outsourced activities, including leveraging AI for process enhancement.
  • Partner with vendors to support execution of operational production plans and contractual requirements.
  • Monitor vendor performance and identify opportunities to improve efficiency, quality, and cost management.
  • Collaborate with QRA Compliance to support development and maintenance of quality assurance protocols.
  • Conduct audits and assessments to ensure accuracy, completeness, and efficiency.
  • Research and evaluate technological solutions, including AI/NLP tools.
  • Partner with Data Science, IT, and Sourcing teams to support deployment of AI solutions.
  • Collaborate with cross-functional teams to support operational goals.
  • Identify and implement process improvements.
  • Monitor and analyze key performance indicators (KPIs).
  • Gather and translate business requirements into actionable recommendations.
  • Assess build vs. buy AI solutions.
  • Support evaluation and monitoring of AI solution performance.
  • Provide guidance and informal coaching to stakeholders as needed.
  • Perform any other job related duties as requested.

Education and Experience:
  • Bachelor's degree in Health Administration, Healthcare Management, or a related field required
  • Master's degree is preferred
  • Equivalent years of relevant work experience may be accepted in lieu of required education
  • Seven (7) years experience in risk adjustment, medical record review, coding, or quality management required
  • Two (2) years experience with AI solutions in a healthcare setting required
  • Leadership experience preferred
Competencies, Knowledge and Skills:
  • Knowledge of ICD-10 Coding
  • Knowledge of HCC Risk Adjustment models
  • Knowledge of CMS regulatory guidelines
  • Strong analytical and problem-solving skills
  • Ability to apply AI technologies in healthcare
  • Strong communication and collaboration skills
  • Ability to influence stakeholders without direct authority
Licensure and Certification:
  • None
Working Conditions:
  • General office environment; may be required to sit or stand for extended periods of time
  • Travel is not typically required

Compensation Range:
$83,000.00 - $132,800.00
CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
  • Fostering a Collaborative Workplace Culture
  • Cultivate Partnerships
  • Develop Self and Others
  • Drive Execution
  • Influence Others
  • Pursue Personal Excellence
  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
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