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Risk Adjustment Coder Jobs in California (NOW HIRING)

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Risk Adjustment Coder information

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$15

$27

$42

How much do risk adjustment coder jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for risk adjustment coder in California is $27.13, according to ZipRecruiter salary data. Most workers in this role earn between $18.75 and $34.18 per hour, depending on experience, location, and employer.

What is a risk adjustment coder?

Risk Adjustment Coders are healthcare professionals who review and analyze patient medical records to ensure accurate coding of diagnoses and procedures for risk adjustment purposes. Their work is crucial for health plans and providers, as it affects reimbursement rates and compliance with government programs like Medicare Advantage and the Affordable Care Act. These coders use specialized knowledge of coding systems, such as ICD-10, to assign appropriate codes that reflect patients’ health status and help organizations receive proper funding for patient care.

What are the key skills and qualifications needed to thrive as a risk adjustment coder, and why are they important?

To thrive as a Risk Adjustment Coder, you need a solid understanding of medical coding (especially ICD-10-CM), healthcare regulations, and risk adjustment methodologies, typically supported by certifications like CRC or CPC. Proficiency with coding software, electronic health records (EHR) systems, and auditing tools is essential. Attention to detail, analytical thinking, and strong organizational skills set top performers apart in this role. These competencies ensure accurate coding, compliance, and optimal reimbursement for healthcare organizations.

What are some common challenges faced by risk adjustment coders, and how can they be overcome?

Risk Adjustment Coders often encounter challenges such as interpreting complex medical documentation and ensuring accurate code assignment to reflect patient risk profiles. Keeping up with frequent updates to coding guidelines and payer requirements can also be demanding. To overcome these challenges, coders should engage in continuous education, actively participate in team discussions to clarify ambiguities, and utilize available coding resources or auditing tools. Strong communication with providers and attention to detail are key to maintaining compliance and high-quality coding standards.

What is the difference between Risk Adjustment Coder vs Medical Coder?

AspectRisk Adjustment CoderMedical Coder
CertificationsCPR, RHIT, CCS, or CPC often preferredCCS, CPC, or CPC-H
Work EnvironmentHealthcare facilities, insurance companies, remoteHospitals, clinics, physician offices
Industry UsageHealth plans, risk adjustment programsGeneral medical billing and coding

Both Risk Adjustment Coders and Medical Coders require similar certifications and work in healthcare settings. However, Risk Adjustment Coders focus on coding for risk adjustment models used by insurance companies, while Medical Coders handle broader medical billing and coding tasks. Understanding these differences helps professionals choose the right career path and employers.

How much do risk adjustment coders make in the US?

Risk adjustment coders in the US typically earn between $50,000 and $75,000 annually, depending on experience, certification, and location. Experienced coders with certifications like CPC or CCS may earn higher salaries, especially in healthcare hubs or with specialized skills in coding software and compliance.

How to become a risk adjustment coder?

To become a risk adjustment coder, individuals typically need a high school diploma or equivalent, followed by specialized training in medical coding and risk adjustment principles. Certification through organizations like the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA) is often required or preferred, and proficiency with coding tools and medical record review is essential.

Is risk adjustment coding a good career?

Risk adjustment coding is a growing field within healthcare that involves reviewing medical records and assigning codes to accurately reflect patient health status for insurance purposes. It requires knowledge of medical terminology, coding systems like ICD-10, and often certification such as CPC, making it a stable career with opportunities for advancement and specialization.

What are the most commonly searched types of Risk Adjustment Coder jobs in California?

The most popular types of Risk Adjustment Coder jobs in California are:

What are popular job titles related to Risk Adjustment Coder jobs in California?

For Risk Adjustment Coder jobs in California, the most frequently searched job titles are:

What job categories do people searching Risk Adjustment Coder jobs in California look for?

The top searched job categories for Risk Adjustment Coder jobs in California are:

What cities in California are hiring for Risk Adjustment Coder jobs?

Cities in California with the most Risk Adjustment Coder job openings:

Risk Adjustment Coder jobs near you
Infographic showing various Risk Adjustment Coder job openings in California as of August 2026, with employment types broken down into 74% Full Time, 15% Part Time, and 11% Contract. Highlights an 77% In-person, and 23% Remote job distribution, with an average salary of $56,433 per year, or $27.1 per hour.

HEALTH CODER - HCC & RISK ADJUSTMENT

NORTH EAST MEDICAL SERVICES

Burlingame, CA • On-site

$58.95 - $67.16/hr

Other

Re-posted 20 days ago

Job description

Job Details

Job Location: Burlingame, CA 94010
Salary Range: $42.79 - $48.75 Hourly

ESSENTIAL JOB FUNCTIONSHCC Coding and Risk Adjustment (RA) Program Support
  • Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
  • Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
  • Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
Provider Training and Clinical Documentation Improvement (CDI)
  • Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
  • Provide one‑on‑one and group training to providers and clinical staff to improve documentation quality and accuracy.
  • Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
Data Analysis and Reporting
  • Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
  • Generate reports and dashboards to track coding performance and documentation accuracy.
  • Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
Compliance and Continuous Improvement
  • Stay up‑to‑date with changes in coding, risk adjustment, and Medicare regulations.
  • Assist in the development and implementation of internal coding policies and procedures.
  • Participate in quality improvement initiatives related to coding and documentation.
  • Perform other job duties as required by manager/supervisor.
Education & Certification
  • BS/BA Degree in Health Science or General Education is required.
  • Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
  • Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
Experience
  • Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
  • Experience in provider education, clinical documentation improvement (CDI), and chart audits.
  • Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
Skills & Competencies
  • Excellent communication, presentation, and interpersonal skills.
  • Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
  • Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
  • Proficiency in electronic health records (EHR) and coding software.
  • Strong analytical and problem‑solving skills.
Language
  • Must be able to fluently speak, read and write English.
  • Fluency in other languages is an asset.
Status

This is an FLSA Non‑exempt position.

This is not an OSHA high‑risk position.

This a full‑time position.

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