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Risk Adjustment Jobs (NOW HIRING)

Mass Advantage

Manager, Risk Adjustment

Worcester, MA · On-site

We are looking for a Manager of Risk Managment to oversee Mass Advantages's full suite of Risk Adjustment activities. This position is responsible for the strategy, execution and performance of ...

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on ...

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on ...

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on ...

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Risk Adjustment information

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$74

How much do risk adjustment jobs pay per hour?

As of Jun 11, 2026, the average hourly pay for risk adjustment in the United States is $30.34, according to ZipRecruiter salary data. Most workers in this role earn between $19.47 and $38.70 per hour, depending on experience, location, and employer.

What is risk adjustment in healthcare?

Risk adjustment is a statistical process used in healthcare to account for the underlying health status and related costs of patients when comparing outcomes or setting payments. It helps ensure that providers or health plans are fairly compensated for caring for sicker patients and prevents them from being penalized for taking on higher-risk individuals. By considering factors such as age, gender, and chronic conditions, risk adjustment creates a more level playing field and promotes quality care across diverse populations.

What is the difference between Risk Adjustment vs Coding Specialist?

AspectRisk AdjustmentCoding Specialist
Required CredentialsCertifications like RHIA, RHIT, or CCS; knowledge of risk modelsCertifications such as CPC, CCS; coding accuracy skills
Work EnvironmentHealthcare organizations, insurance companies, risk adjustment teamsHospitals, clinics, medical billing departments
Industry UsageUsed to adjust payments based on patient risk profilesUsed to translate medical records into billing codes
Common Search/ComparisonOften compared for roles in healthcare finance and reimbursementCompared for medical coding and billing roles

Risk Adjustment professionals focus on analyzing patient data to ensure accurate risk scores for reimbursement, while Coding Specialists translate medical records into standardized codes for billing. Both roles require healthcare knowledge but serve different functions within the healthcare revenue cycle.

How does a Risk Adjustment professional typically collaborate with other departments to ensure accurate data capture and reporting?

Risk Adjustment professionals frequently work cross-functionally with coding specialists, data analysts, and clinicians to ensure that patient diagnoses and health records are accurately documented and coded. This collaboration often involves regular meetings to review medical records, resolve discrepancies, and discuss updates in coding guidelines. By working closely with these teams, Risk Adjustment staff help ensure compliance with industry standards and maximize reimbursement accuracy, all while improving the quality of patient data. Strong communication and teamwork skills are essential in this role to effectively bridge gaps between clinical and administrative functions.

What are the key skills and qualifications needed to thrive as a Risk Adjustment Specialist, and why are they important?

To thrive as a Risk Adjustment Specialist, you need a strong understanding of medical coding (ICD-10), healthcare regulations, and data analysis, often supported by a degree in health information management or a related field. Familiarity with coding software, EHR systems, and certifications such as CRC (Certified Risk Adjustment Coder) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for accurately interpreting medical records and collaborating with providers. These skills and qualifications are essential to ensure accurate risk scoring, regulatory compliance, and proper reimbursement in the healthcare system.
More about Risk Adjustment jobs
What cities are hiring for Risk Adjustment jobs? Cities with the most Risk Adjustment job openings:
What are the most commonly searched types of Risk Adjustment jobs? The most popular types of Risk Adjustment jobs are:
What states have the most Risk Adjustment jobs? States with the most job openings for Risk Adjustment jobs include:
What job categories do people searching Risk Adjustment jobs look for? The top searched job categories for Risk Adjustment jobs are:
Risk Adjustment jobs near you
Infographic showing various Risk Adjustment job openings in the United States as of June 2026, with employment types broken down into 1% Locum Tenens, 2% Internship, 71% Full Time, 10% Part Time, 15% Contract, and 1% Nights. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $63,100 per year, or $30.3 per hour.

Risk Adjustment Analyst

PCC MEDICAL HOLDINGS LLC

North Palm Beach, FL • On-site

$65K - $75K/yr

Full-time

Posted 14 days ago

Job description

Risk Adjustment Specialist – Primary Care
Location: Remote
Employment Type: Full-Time
Pay : $65K - $75K
About Us
Here at Physician Care Centers, we are a patient-centered primary care organization committed to delivering high-quality, value-based care. Our team partners with providers to improve patient outcomes while ensuring accurate clinical documentation and coding practices.
Position Overview
We are seeking a detail-oriented Risk Adjustment Specialist to support our value-based care initiatives. In this role, you will work closely with providers and clinical teams to ensure accurate documentation and coding of patient conditions, helping reflect the true complexity of our patient population.
What You’ll Do
  • Perform pre-visit and post-visit chart reviews to identify risk adjustment opportunities
  • Ensure accurate ICD-10-CM and HCC coding based on clinical documentation
  • Partner with providers to clarify diagnoses and improve documentation quality
  • Educate providers and staff on risk adjustment and coding best practices
  • Track and monitor Risk Adjustment Factor (RAF) scores and performance metrics
  • Support internal and external audits and ensure compliance with Centers for Medicare & Medicaid Services (CMS) guidelines
  • Stay current on coding updates and value-based care requirements
What We’re Looking For
  • 2+ years of experience in risk adjustment, medical coding, or primary care
  • Strong knowledge of ICD-10-CM and HCC coding
  • Certification such as CRC or CPC preferred
  • Experience working with electronic health records (EHRs)
  • Excellent attention to detail and analytical skills
  • Strong communication skills and ability to collaborate with providers
Why Join Us?
  • Competitive salary and benefits package
  • Opportunity to work in a growing value-based care environment
  • Collaborative and supportive team culture
  • Professional development and certification support