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Remote Risk Adjustment Coding Jobs in Garner, NC

Labcorp

Director, Laboratory CPT Coding

Durham, NC · On-site +1

$102K - $133K/yr

... remote workdays per week, supporting both collaboration and flexibility, with occasional onsite ... Compliance, Quality & Risk Management * Ensure compliance with CMS, AMA, OIG, commercial payer, and ...

New

Berriehill Research

Staff Scientist

Raleigh, NC · On-site +1

Remote work may be considered for the right candidate. What you will do as a staff scientist ... computer codes (e.g., FORTRAN, C, C++, and/or Python) for natural hazard risk assessment.

New

Berriehill Research

Senior Scientist

Raleigh, NC · On-site +1

$80K - $110K/yr

Remote work may be considered for the right candidate. What you will do as a senior scientist ... computer codes (e.g., FORTRAN, C, C++, and/or Python) for natural hazard risk assessment.

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All JobsRisk Adjustment Coding JobsRemote Risk Adjustment Coding JobsRemote Risk Adjustment Coding Jobs in Garner, NC

Remote Risk Adjustment Coding information

See Garner, NC salary details

$15

$19

$21

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

As of Jul 31, 2026, the average hourly pay for remote risk adjustment coding in Garner, NC is $19.17, according to ZipRecruiter salary data. Most workers in this role earn between $16.06 and $20.34 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 Garner, NC? For Remote Risk Adjustment Coding jobs in Garner, NC, the most frequently searched job titles are:
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What cities near Garner, NC are hiring for Remote Risk Adjustment Coding jobs? Cities near Garner, NC 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 Garner, NC as of June 2026, with employment types broken down into 92% Full Time, 6% Part Time, and 2% Contract. Highlights an 51% Physical, 3% Hybrid, and 46% Remote job distribution, with an average salary of $39,866 per year, or $19.2 per hour.

Systems Analyst - Payer Encounter Management Platform

Veradigm

Raleigh, NC • Remote

$69K - $97K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 5 days ago

Job description

Veradigm is a healthcare analytics and technology company that helps health plans and atrisk providers improve Risk Adjustment and Quality outcomes across HIX, Medicare Advantage, and Medicaid. With advanced analytics and realtime intelligence, we give clients clear visibility into member and provider activity so they can close documentation, coding, and quality gaps more efficiently.

The Veradigm Encounter Management Platform is a centralized solution that processes, validates, and submits encounter and supplemental data for Medicare, Medicaid, ACA, and other government programs. It streamlines ingestion, edit resolution, submission readiness, and CMS response handling, giving health plans and BPO partners a reliable, compliant way to manage largescale encounter operations.

Job Summary

The Systems Analyst works primarily with enterprise customers of Veradigm's Encounter Management Platform, proactively assisting them with post- sales installation, configuration, upgrade, troubleshooting and day to day operational management. Responsibilities include taking a proactive leadership role working with the Engineering team and Customers to triage and resolve highly complex, technical, and application-related issues which impact product performance in customer-specific environments, or issues that directly hamper a broader customer adoption of Veradigm's Encounter Management Platform. In addition to working with customers, the Systems Analyst will routinely partner with our Development, Sustaining Engineering and Sales Engineering organizations to resolve support issues, document bugs, provide UAT on product builds, and ensure that new and newly upgraded server installations are successful.

What you will contribute:

  • Support encounter data reporting processes for EDPS, RAPS and the EDGE server, including tracking, reporting, and resolving rejections
  • Conduct gap analysis and data validation, identifying possible issues in data submission and determining financial impact.
  • Analyze and reconcile claims and encounter data which will include 837 EDI encounter files for EDPS, RAPS and Edge Server submission files
  • Perform research in the encounter management system and liaison with the CSSC Helpdesk for exception resolution
  • Be comfortable with raw data files in their native format and accessing these through various servers
  • Partner with Product Support Engineers and development teams as necessary
  • Assist development team with performance analysis and testing during release cycles for service packs, hot fixes etc
  • Answer email and phone requests for help from customers
  • Collaborate in virtual teamwork with other Product Support staff
  • Host online troubleshooting and investigation sessions on customer's production environments
  • Deliver a consistent, responsive and satisfying customer experience with each contact
  • Collect all necessary problem details from customers to be able to effectively see the problem to resolution
  • Successfully reproduce customer issues in a controlled test environment
  • Follow standard operational procedures for case management
  • Continuously improve troubleshooting skills, product expertise, and knowledge on related technical topics
  • Perform ACA and MA Submissions for Clients
  • Understand RAPS and EDPS filtering logic which CMS uses for Risk Adjustment and/or Risk Score calculations
  • Monitor CMS data submission deadlines for both MA and ACA lines of business

The ideal candidate will have:

Academic and Professional Qualifications:

Bachelor's Degree in Health IT/Informatics/Management Information Systems or related field required

Experience:

  • 2+ years of professional experience in Risk Adjustment data management
  • Understanding of claims data, encounter response files, 837 EDI encounter files, EDGE/MA billing & business rules as well as MA filtering logic for EDPS
  • Experience with CMS Submissions Process and EDI transactions
  • Excellent time management and organizational skills necessary
  • Prior experience troubleshooting performance problems that may have many underlying causes such as Disk, Database, Network, Messaging and other platform / 3rd party solutions
  • Experience with managing product back end and webservices
  • Ability to guide customers remotely through complex, multi-server deployments and upgrades for enterprise products
  • Familiarity with EDI Standards such as X12, EDIFACT, HL7, NCPDP and knowledge of HIPAA transactions
  • Prior knowledge of 837's along with various loops and segments and an understanding of the requirements set forth by CMS for EDPS submission files
  • Working knowledge in SQL scripts is a plus
  • Good written and verbal skills.
  • Knowledge in CMS model changes is a plus
  • Knowledge in CMS Risk Score and Risk Adjustment methodologies is a plus
  • Knowledge in Medicaid is a plus

Travel Requirements:

Less than 5%

Compensation Range:

$69,852-$97,094

Compensation for this job is subject to market conditions, geographic considerations, the candidate's unique skills and experience, state and local laws, and budget. Our commitment to pay transparency is a testament to our dedication to creating a fair, equitable, and inclusive workplace. By continuously analyzing market trends, staying abreast of changes in state laws, and making budgetary adjustments accordingly, we strive to ensure that our compensation practices reflect the value we place on our associates' unique contributions and support their professional growth.

Enhancing Lives and Building Careers

Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work and to further their professional development. Together, we are In the Network. Interested in learning more?

Take a look at our Culture, Benefits, Early Talent Program, and Additional Openings.

We strongly advocate that our associates receive all CDC recommended vaccinations in prevention of COVID-19.

Visa Sponsorship is not offered for this position.

At Veradigm, our greatest strength comes from bringing together talented people with diverse perspectives to support the needs of healthcare providers, life science companies, health plans, and the patients they serve. The Veradigm Network is a dynamic, open community of solutions, external partners, and cutting-edge artificial intelligence technologies that provide advanced insights, technology, and data-driven solutions. Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.

Veradigm's policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.

From a "VEVRAA Federal Contractor" We request Priority Referral of Protected Veterans

This is an official Veradigm Job posting. To avoid identity theft, please only consider applying to jobs posted on our official corporate site.

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