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Remote Risk Adjustment Coding Jobs in Edgewood, KY

MM International

SDET - 100 % Remote

Cincinnati, OH · Remote

$51.25 - $66/hr

Remote - 100% allowable Perm/Contract/CTH: Contract (potential to extend or convert based on ... risk-based testing · Experience with a code repository and versioning system such as GitHub · ...

Ledcor Group

Permitting Specialist

Cincinnati, OH · On-site +1

Your expertise in building codes, ordinances, and permitting procedures will help us deliver world ... This role will begin as a remote (work-from-home) position and will transition to a full-time, in ...

BHDP Architecture

Architect

Cincinnati, OH · On-site +1

Hybrid (remote or in-office) Friday Employment Type: Full-time At BHDP, we believe great design ... Escalates high-risk items, documents key decisions, drives consistent implementation across the ...

Ledcor Group

Permitting Specialist

Florence, KY · Remote

Serves as subject matter expert on matters related to local municipal and state codes * Coordinates ... This has the flexibility of being a remote position * This position will require 15% travel ...

Smart Data

2223 Principal Software Engineer

Cincinnati, OH · Remote

$154K - $172K/yr

REMOTE EST/CST Years of Experience: 10+ What You'll Do Newline™ is an enterprise-grade embedded ... Improve platform reliability through code changes, automation, observability, and better system ...

New

System One

Senior Java Developer -

Evendale, OH · Remote

$110K - $130K/yr

Direct Hire Compensation: $110,000 - $130,000 Hybrid - onsite Tue, Wed, Thr, remote Mon, Fri ... efficiencies, reduce risk, ensure compliance, and promote business agility and innovation.

System One

Senior Java Developer

Evendale, OH · Remote

$110K - $130K/yr

Direct Hire Compensation: $110,000 - $130,000 Hybrid - onsite Tue, Wed, Thr, remote Mon, Fri ... efficiencies, reduce risk, ensure compliance, and promote business agility and innovation.

System One

Senior Java Developer

Evendale, OH · Remote

$110K - $130K/yr

Direct Hire Compensation: $110,000 - $130,000 Hybrid - onsite Tue, Wed, Thr, remote Mon, Fri ... efficiencies, reduce risk, ensure compliance, and promote business agility and innovation.

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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 Jun 27, 2026, the average hourly pay for remote risk adjustment coding in Edgewood, KY is $21.20, according to ZipRecruiter salary data. Most workers in this role earn between $17.79 and $22.50 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 cities near Edgewood, KY are hiring for Remote Risk Adjustment Coding jobs? Cities near Edgewood, KY with the most Remote Risk Adjustment Coding job openings:
Remote Risk Adjustment Coding jobs near you
Director of Revenue Cycle Management

Director of Revenue Cycle Management

The HealthCare Connection Inc.

Cincinnati, OH • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Job description

Career Opportunity: Director of Revenue Cycle Management
Reports to: Chief Financial Officer
Organization: The HealthCare Connection (THCC)
Location: Cincinnati, OH - Lincoln Heights (Remote Position)
About The HealthCare Connection:
Founded in 1967, The HealthCare Connection was Ohio’s first Federally Qualified Health Center (FQHC). Our mission is to provide quality and accessible primary healthcare services through community responsive approaches that address financial, geographic, and other barriers to care for residents of northern Hamilton County and surrounding areas. THCC is proudly recognized as a Level 3 Patient Centered Medical Home (PCMH), the highest level of recognition attainable for quality care.
We boast two primary care locations and 6 school-based health centers providing quality value-based care for over 20,000 patients. We provide services in Primary Care, Infectious Disease, Substance Use, Integrated Behavioral Health, Dental Services, Women’s Health, and Pharmacy.
Benefits:
  • Health Insurance and Rewards Program
  • Dental, and Vision Insurance
  • Free Life amp; Short-Term Disability Insurance
  • 403(b) Retirement Plan with employer match
  • Comprehensive Paid Time Off (PTO)
  • 10 Paid Holidays
Position Summary:

The Director of Revenue Cycle is responsible for the strategic oversight and operational management of all revenue cycle functions within the FQHC environment. This role leads efforts related to patient revenue optimization, billing operations, coding compliance, risk-adjustment initiatives, claims management, payer relations, and reimbursement performance. The Director collaborates closely with clinical, operational, finance, and third-party billing teams to ensure compliant, efficient, and financially sustainable revenue cycle operations that support access to high-quality patient care.

Key Responsibilities:
  • Direct and oversee all revenue cycle operations including registration, charge capture, coding, billing, claims processing, payment posting, denial management, collections, and reimbursement analysis.
  • Lead revenue cycle strategy and performance improvement initiatives to maximize cash flow, reduce denials, and improve financial outcomes.
  • Monitor and analyze key revenue cycle metrics including A/R trends, denial rates, clean claim rates, payer mix, days in A/R, and collection performance.
  • Ensure compliance with FQHC billing regulations, HRSA requirements, Medicare, Medicaid, commercial payer guidelines, and other applicable regulatory standards.
  • Oversee coding compliance and risk-adjustment capture (HCC) efforts in collaboration with providers and coding staff.
  • Manage relationships and accountability with third-party billing vendors, clearinghouses, and payer representatives.
  • Develop and implement policies, procedures, workflows, and internal controls related to revenue cycle operations.
  • Partner with clinical and operational leadership to improve documentation accuracy, charge integrity, and reimbursement outcomes.
  • Coordinate payer credentialing oversight and support contracting initiatives as needed.
  • Lead audits, payer reviews, repayment responses, and corrective action planning when necessary.
  • Prepare and present revenue cycle reports, financial analyses, and operational updates to executive leadership.
  • Identify opportunities for workflow optimization, automation, EHR improvements, and operational efficiencies.
  • Support annual budgeting, forecasting, and financial planning activities related to patient revenue.
  • Supervise, mentor, and evaluate revenue cycle staff while fostering accountability and professional development.
  • Maintain confidentiality and ensure compliance with HIPAA and organizational policies.
Qualifications:
  • Bachelor’s degree in healthcare administration, business, finance, health information management, or related field preferred; equivalent experience may be considered.
  • Minimum of 5 years of progressive revenue cycle experience in healthcare required.
  • Minimum of 2 years of leadership or supervisory experience required.
  • Strong knowledge of CPT, HCPCS, ICD-10, FQHC billing regulations, PPS reimbursement methodologies, Medicare, Medicaid, and commercial payer requirements.
  • Experience managing denials, payer audits, appeals, and reimbursement optimization initiatives.
  • Knowledge of coding compliance and documentation improvement practices.
  • Strong analytical, organizational, communication, and problem-solving skills.
  • Experience working with EHR and practice management systems.
  • Ability to collaborate effectively with clinical, operational, and financial leadership teams.
Preferred:
  • Experience in a Federally Qualified Health Center (FQHC) strongly preferred.
  • Certified Professional Coder (CPC), Certified Revenue Cycle Representative (CRCR), Certified Coding Specialist (CCS), or related certification preferred.
  • Experience overseeing outsourced billing vendors.
  • Familiarity with NextGen, EPIC, or similar healthcare systems.
  • Experience with value-based care, quality incentive programs, and risk-adjustment methodologies.
Equal Employment Opportunity/Drug-Free Workplace:
The HealthCare Connection is focused on creating a community that promotes dignity and respect for employees, patients and other community members. THCC is an Equal Opportunity Employer and a Drug-Free Workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, military status or other characteristics protected by law and will not be discriminated against based on disability.
THCC will only employ those who are legally authorized to work in the United States. Any offer of employment is conditioned upon the successful completion of a background check and a drug screen.

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