ZipRecruiter

Log In

2

Remote Risk Adjustment Coding Jobs in Springfield, MO

BillionToOne

Account Executive

Springfield, MO · Remote

$184K - $248K/yr

Responsibilities: * Increasing utilization of UNITY Fetal Risk Screen and driving market ... Demonstrated values and ethics that support BillionToOne's mission, goals, and professional code of ...

All JobsRemote Risk Adjustment Coding JobsRemote Risk Adjustment Coding Jobs in Springfield, MO

Remote Risk Adjustment Coding information

See Springfield, MO salary details

$15

$19

$21

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

As of Jun 25, 2026, the average hourly pay for remote risk adjustment coding in Springfield, MO is $19.56, according to ZipRecruiter salary data. Most workers in this role earn between $16.39 and $20.77 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 Springfield, MO? For Remote Risk Adjustment Coding jobs in Springfield, MO, the most frequently searched job titles are:
What job categories do people searching Remote Risk Adjustment Coding jobs in Springfield, MO look for? The top searched job categories for Remote Risk Adjustment Coding jobs in Springfield, MO are:
What cities near Springfield, MO are hiring for Remote Risk Adjustment Coding jobs? Cities near Springfield, MO 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 Springfield, MO as of June 2026, with employment types broken down into 66% Full Time, 28% Part Time, and 6% Contract. Highlights an 49% Physical, 3% Hybrid, and 48% Remote job distribution, with an average salary of $40,682 per year, or $19.6 per hour.

Workers' Compensation Claims Manager (Remote)

memployersmins

Springfield, MO • Remote

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Job description

Are you an experienced workers’ compensation claims leader who loves developing talent and solving complex problems? MEM Insurance is looking for a Claims Manager to lead a team of seasoned claims professionals handling higher-complexity workers’ compensation claims. In this role, you’ll blend hands-on technical guidance with people leadership—coaching your team on complex coverage, litigation strategy and highexposure claims while fostering a culture of accountability, collaboration and continuous improvement.
 
Reporting to the Claims Operations Manager, you will oversee day-to-day operations for a complex claims team, drive consistent, highquality outcomes, and champion process enhancements that improve the experience for our policyholders, injured workers and internal partners. If you’re energized by mentoring others, making strategic decisions and shaping how complex claims are managed, this is a great opportunity to make a meaningful impact on our organization and the customers we serve.
 
 Essential Duties and Responsibilities
Listed in order of importance to the role.
  • Lead, coach and develop a high-performing team of experienced workers’ compensation claims professionals managing higher complexity claims, setting clear expectations and fostering a culture of learning, ownership and results.
  • Provide hands-on technical oversight for claims involving significant financial exposure, complex coverage issues, litigation and extended life cycles, guiding strategy and key claim decisions.
  • Conduct regular quality assurance and POA sessions on highexposure and complex claims, delivering targeted feedback to strengthen technical accuracy, reserve adequacy, settlement strategies and overall claim outcomes.
  • Monitor workloads and staffing levels to ensure balanced caseloads, effective workflow management and alignment with departmental objectives; recommend staffing or resource adjustments as needed.
  • Review and approve reserves, settlements and payments above adjuster authority, ensuring decisions comply with company standards, statutory regulations and overall claims strategy.
  • Use performance metrics and claim outcomes to evaluate team effectiveness, identify trends, and implement action plans that improve results, efficiency and consistency.
  • Enhance onboarding, training and ongoing development programs so new and existing team members quickly build and deepen advanced skills such as reserve analysis, litigation management, negotiation and complex claims resolution.
  • Drive continuous improvement and innovation by identifying opportunities to streamline workflows, leveraging technology and automation tools, and removing barriers that impact productivity and service.
  • Promote strong cross-functional collaboration with CompLegal, Risk Services and other internal partners to ensure a unified, proactive approach to claims strategy and execution.
  • Serve as a visible, trusted leader and liaison between senior leadership and the team, keeping employees informed of organizational goals, initiatives and process updates while aligning team efforts with MEM’s vision, mission and values.
 Qualifications
  • Bachelor’s Degree preferred; a combination of education and relevant experience will be considered.
  • 10–15 years of progressive workers’ compensation claim experience, including handling highercomplexity claims.
  • Minimum of 1 year of experience in a leadership role or in a capacity heavily involved in planning, managing and organizing resources.
  • Professional designations such as SCLA, CPCU and/or AIC are beneficial.
  • Valid driver’s license required.
  • Claim adjusting license beneficial, but not required.
 Company Culture and Values
At MEM Insurance, we are committed to our vision, mission, and values. We foster a culture of collaboration, integrity, and innovation. Our team is passionate about delivering exceptional service to our customers while supporting each other’s growth and success. We believe in accountability, continuous learning, and creating an environment where employees feel valued and empowered.
 
 Connection and Belonging
MEM Insurance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that varied perspectives drive innovation and strengthen our ability to serve our customers and communities.
 
 Total Rewards Overview
  • Health Plans: Medical, Dental, and Vision
    Includes fertility benefits, fully paid preventative care, and adult orthodontia.
  • Employer-Paid Life and Disability Benefits:
    Life Insurance (3x base salary), AD&D, Short and Long-term Disability.
  • Wellness and Recognition Program: Employer-paid incentives for employees and spouses.
  • Flexible Spending Account and Dependent Care options
  • Health Savings Account: Generous employer contribution.
  • Time Away from Work:
    Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days Paid Parental Leave, Marriage, Bereavement, and Jury Duty leave.
  • Employee Assistance Programs
  • 401k Retirement Plan: Employer match and profit sharing.
  • Adoption Assistance and Tuition Assistance
 
Notice Regarding Use of Artificial Intelligence
MEM may use artificial intelligence (AI) tools to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will comply with all applicable laws.

Apply