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Remote Risk Adjustment Coding Jobs in Fontana, CA

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... Must have thorough knowledge of both CPT and ICD coding * Ability to interface with claims staff ...

REMOTE- Payroll Analyst

Chino, CA ยท On-site +1

$32 - $40/hr

... situations, pay adjustments, incentives, retro pay, and off-cycle transactions. * Review and ... Maintain payroll system configurations, including earnings codes, deduction setups, tax profiles ...

UR Intake Specialist

Rancho Cucamonga, CA ยท Remote

$16.90 - $26.92/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Takes calls relating to ... The level may impact the salary range and these adjustments would be clarified during the offer ...

CA Claims Specialist

Rancho Cucamonga, CA ยท Remote

$25.48 - $41.09/hr

This is a remote position handling future medical claims. Candidates must hold a California self ... The level may impact the salary range and these adjustments would be clarified during the offer ...

CA Senior Claims Specialist

Rancho Cucamonga, CA ยท Remote

$29.35 - $47.28/hr

This is a remote position but candidate must reside in California and hold California self ... The level may impact the salary range and these adjustments would be clarified during the offer ...

CA Senior Claims Specialist

Rancho Cucamonga, CA ยท Remote

$29.35 - $47.28/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Receives Workers' Compensation ... The level may impact the salary range and these adjustments would be clarified during the offer ...

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Remote Risk Adjustment Coding information

See Fontana, CA salary details

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

As of Jun 29, 2026, the average hourly pay for remote risk adjustment coding in Fontana, CA is $21.86, according to ZipRecruiter salary data. Most workers in this role earn between $18.32 and $23.22 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 Fontana, CA? For Remote Risk Adjustment Coding jobs in Fontana, CA, the most frequently searched job titles are:
What cities near Fontana, CA are hiring for Remote Risk Adjustment Coding jobs? Cities near Fontana, CA with the most Remote Risk Adjustment Coding job openings:
Infographic showing various Remote Risk Adjustment Coding job openings in Fontana, CA as of June 2026, with employment types broken down into 63% Full Time, 34% Part Time, and 3% Contract. Highlights an 38% Physical, 3% Hybrid, and 59% Remote job distribution, with an average salary of $45,468 per year, or $21.9 per hour.

Risk Adjustment Coding Specialist II - Orange County

Astrana Health, Inc.

Orange, CA โ€ข Remote

$70K - $85K/yr

Full-time

Posted 7 days ago


Job description

Description
We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Orange County market.ย  In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. Youโ€™ll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, youโ€™ll track and report on key performance metricsโ€”such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success.ย 
We are seeking candidates who have experience with provider education and at least 3-5 years of risk adjustment experience! This position requires travel to provider offices up to 75% of the time OC.
Our Values:ย 
  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence
  • Be Innovative
  • Work As One Team

What You'll Do
  • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company
  • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC)ย 
  • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelinesย 
  • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing
  • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
  • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives.
  • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work.
  • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager.
  • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I
  • Other duties as assigned

Qualifications
  • Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification -ย  Certified Coding Specialist (CCS-P), CCS, or CPC.
  • At least 3 years of experience in risk adjustment coding and/or billing experience required
  • Reliable transportation/Valid Driverโ€™s License/Must be able to travel up to 75% of work time
  • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
  • Excellent presentation, verbal and written communication skills, and ability to collaborateย 
  • Must possess the ability to educate and train provider office staff members
  • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.
You're great for this role if:ย  ย ย 
  • Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC
  • Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
  • Strong PowerPoint and public speaking experience
  • Ability to work independently and collaborate in a team setting
  • Experience with Monday.com
  • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting

Environmental Job Requirements and Working Conditions
  • The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
  • This role follows a hybrid work structure where the expectation is to work on the field and at home on a weekly basis. This position requires up to 75% travel to provider offices in Orange County.ย 
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.ย  ย ย 

Additional Information:ย  ย  ย 
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.