Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance ...
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance ...
Clinical Documentation Integrity (CDI) Review
Costa Mesa, CA · On-site
$36.75 - $49.50/hr
Leveraging knowledge of ICD-10, CPT, and other applicable coding guidelines, this role helps optimize risk adjustment, reimbursement, quality reporting, regulatory compliance, and clinical data ...
Quick apply
Clinical Documentation Integrity (CDI) Review
Costa Mesa, CA · On-site
$36.75 - $49.50/hr
Leveraging knowledge of ICD-10, CPT, and other applicable coding guidelines, this role helps optimize risk adjustment, reimbursement, quality reporting, regulatory compliance, and clinical data ...
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance ...
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance ...
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance ...
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance ...
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance ...
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance ...
Strategy Analyst V, Risk Adjustment- CDI Support
Pasadena, CA · On-site
$110 - $165/hr
... accuracy, coding integrity, and regulatory compliance. Partner with operational, clinical ... Risk Adjustment initiatives. Job Summary Drives strategy development by defining complex business ...
Strategy Analyst V, Risk Adjustment- CDI Support
Pasadena, CA · On-site
$110 - $165/hr
... accuracy, coding integrity, and regulatory compliance. Partner with operational, clinical ... Risk Adjustment initiatives. Job Summary Drives strategy development by defining complex business ...
QCDI Coder
Rancho Cordova, CA · Remote
$32.38 - $48.17/hr
HCC, risk adjustment, or specialty coding experience preferred * Experience with MSSP preferred * Technical/software acumen preferred Where You'll Work Dignity Health Medical Foundation, established ...
QCDI Coder
Rancho Cordova, CA · Remote
$32.38 - $48.17/hr
HCC, risk adjustment, or specialty coding experience preferred * Experience with MSSP preferred * Technical/software acumen preferred Where You'll Work Dignity Health Medical Foundation, established ...
Jr. Quality Improvement Coder
Orange, CA · On-site
... and Risk Adjustment Factor. * Conduct internal reviews of documentation and billing on a timely ... Identify coding and billing risk areas, conduct focused reviews. Ensure accurate coding by ...
Jr. Quality Improvement Coder
Orange, CA · On-site
... and Risk Adjustment Factor. * Conduct internal reviews of documentation and billing on a timely ... Identify coding and billing risk areas, conduct focused reviews. Ensure accurate coding by ...
Jr. Quality Improvement Coder
Orange, CA · On-site
$27 - $30/hr
... and Risk Adjustment Factor. * Conduct internal reviews of documentation and billing on a timely ... Identify coding and billing risk areas, conduct focused reviews. Ensure accurate coding by ...
Jr. Quality Improvement Coder
Orange, CA · On-site
$27 - $30/hr
... and Risk Adjustment Factor. * Conduct internal reviews of documentation and billing on a timely ... Identify coding and billing risk areas, conduct focused reviews. Ensure accurate coding by ...
Coding Manager
Arcata, CA · On-site
$94.60 - $111.29/hr
Supports value-based care, risk adjustment, and quality initiatives impacting reimbursement and ... Monitors coder work queues and reports to identify improvement opportunities;Reviews work queues ...
Coding Manager
Arcata, CA · On-site
$94.60 - $111.29/hr
Supports value-based care, risk adjustment, and quality initiatives impacting reimbursement and ... Monitors coder work queues and reports to identify improvement opportunities;Reviews work queues ...
Clinical Documentation Integrity Specialist - Registered Nurse
Los Angeles, CA · On-site
$71K - $105K/yr
Active Registered Nurse (RN) license. * 3+ years of experience in Clinical Documentation Integrity, Risk Adjustment, HCC Coding, or Documentation Improvement. Preferred: * NP license. Benefits
Quick apply
Clinical Documentation Integrity Specialist - Registered Nurse
Los Angeles, CA · On-site
$71K - $105K/yr
Active Registered Nurse (RN) license. * 3+ years of experience in Clinical Documentation Integrity, Risk Adjustment, HCC Coding, or Documentation Improvement. Preferred: * NP license. Benefits
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
Director of Clinical Services
Long Beach, CA · On-site
$150K - $185K/yr
Oversee interdisciplinary teams including Quality, Risk Adjustment, and Coding staff. * Develop and implement workflows that align with value-based care models. * Ensure integration of clinical data ...
New
Quick apply
Director of Clinical Services
Long Beach, CA · On-site
$150K - $185K/yr
Oversee interdisciplinary teams including Quality, Risk Adjustment, and Coding staff. * Develop and implement workflows that align with value-based care models. * Ensure integration of clinical data ...
New
MSO PHYSICIAN REVIEWER
Burlingame, CA · On-site
$285K - $332K/yr
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
MSO PHYSICIAN REVIEWER
Burlingame, CA · On-site
$285K - $332K/yr
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
MSO PHYSICIAN REVIEWER
Burlingame, CA · On-site
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
MSO PHYSICIAN REVIEWER
Burlingame, CA · On-site
Analyze Hierarchical Condition Category (HCC) coding and Risk Adjustment Factor (RAF) scores to identify documentation gaps and ensure alignment with CMS risk adjustment models. * Support provider ...
$28 - $32/hr
... payment, risk adjustment, quality reporting, and medical expense analysis. What You'll Do * Review inpatient hospital records and assign accurate diagnosis and procedure codes * Determine the ...
$28 - $32/hr
... payment, risk adjustment, quality reporting, and medical expense analysis. What You'll Do * Review inpatient hospital records and assign accurate diagnosis and procedure codes * Determine the ...
MSO MEDICAL DIRECTOR - MEDICARE UNIT
Burlingame, CA · On-site
$341K - $398K/yr
Lead educational initiatives to improve risk adjustment factor (RAF) scores and ensure accurate coding practices. * Analyze risk adjustment data to identify trends and implement strategies for ...
MSO MEDICAL DIRECTOR - MEDICARE UNIT
Burlingame, CA · On-site
$341K - $398K/yr
Lead educational initiatives to improve risk adjustment factor (RAF) scores and ensure accurate coding practices. * Analyze risk adjustment data to identify trends and implement strategies for ...
DRG Coder
$28 - $32/hr
... payment, risk adjustment, quality reporting, and medical expense analysis. What You'll Do * Review inpatient hospital records and assign accurate diagnosis and procedure codes * Determine the ...
Quick apply
DRG Coder
$28 - $32/hr
... payment, risk adjustment, quality reporting, and medical expense analysis. What You'll Do * Review inpatient hospital records and assign accurate diagnosis and procedure codes * Determine the ...
QCDI Coder
Rancho Cordova, CA · Remote
$20 - $26.75/hr
HCC, risk adjustment, or specialty coding experience preferred * Experience with MSSP preferred * Technical/software acumen preferred
New
QCDI Coder
Rancho Cordova, CA · Remote
$20 - $26.75/hr
HCC, risk adjustment, or specialty coding experience preferred * Experience with MSSP preferred * Technical/software acumen preferred
New
Lead educational initiatives to improve risk adjustment factor (RAF) scores and ensure accurate coding practices. * Analyze risk adjustment data to identify trends and implement strategies for ...
Lead educational initiatives to improve risk adjustment factor (RAF) scores and ensure accurate coding practices. * Analyze risk adjustment data to identify trends and implement strategies for ...
Risk Adjustment Coder information
See California salary details
$18.09 is the 25th percentile. Wages below this are outliers.
$15.66 - $18.14
26% of jobs
$18.14 - $20.62
9% of jobs
$20.62 - $23.10
12% of jobs
The median wage is $24.34 / hr.
$23.10 - $25.58
9% of jobs
$25.58 - $28.06
11% of jobs
$28.06 - $30.54
5% of jobs
$32.40 is the 75th percentile. Wages above this are outliers.
$30.54 - $33.02
6% of jobs
$33.02 - $35.50
5% of jobs
$35.50 - $37.98
5% of jobs
$37.98 - $40.46
3% of jobs
$40.46 - $42.94
10% of jobs
$15
$27
$42
How much do risk adjustment coder jobs pay per hour?
What is a risk adjustment coder?
What are the key skills and qualifications needed to thrive as a risk adjustment coder, and why are they important?
What are some common challenges faced by risk adjustment coders, and how can they be overcome?
What is the difference between Risk Adjustment Coder vs Medical Coder?
| Aspect | Risk Adjustment Coder | Medical Coder |
|---|---|---|
| Certifications | CPR, RHIT, CCS, or CPC often preferred | CCS, CPC, or CPC-H |
| Work Environment | Healthcare facilities, insurance companies, remote | Hospitals, clinics, physician offices |
| Industry Usage | Health plans, risk adjustment programs | General 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?
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The most popular types of Risk Adjustment Coder jobs in California are:
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For Risk Adjustment Coder jobs in California, the most frequently searched job titles are:
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The top searched job categories for Risk Adjustment Coder jobs in California are:
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Cities in California with the most Risk Adjustment Coder job openings:

Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 5 days ago
Key responsibilities
Develop deep expertise in MedInsight's risk adjustment software and analytics, and in the surrounding market to engage prospects as a credible advisor.
Build and execute a strategic national territory plan across health plans, provider organizations, ACOs, MSOs, and risk-bearing entities through targeted research, outbound prospecting, and insight-led engagement.
Identify, develop, and rigorously qualify opportunities using a structured sales methodology, mapping decision-makers and influencers across various functions.
Milliman rating
8.5
Based on 7 frontline employees who took The Breakroom Quiz
Job description
Individual(s) must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future.
Company Overview:
Leading with our core values of Quality, Integrity, and Opportunity, MedInsight is one of the healthcare industry’s most trusted solutions for healthcare intelligence. Our company purpose is to empower easy, data-driven decision-making on important healthcare questions. Through our products, education, and services, MedInsight is making an impact on healthcare by helping to drive better outcomes for patients while reducing waste. Over 300 leading healthcare organizations have come to rely on MedInsight analytic solutions for healthcare cost and care management.
MedInsight is a subsidiary of Milliman; a global, employee-owned consultancy providing actuarial consulting, retirement funding and healthcare financing, enterprise risk management and regulatory compliance, data analytics and business transformation as well as a range of other consulting and technology solutions.
Position Summary:
MedInsight is hiring a Business Development Executive to lead new-logo acquisition and expansion revenue across our risk adjustment portfolio. This is a selling specialist role: you will own a national territory selling MedInsight’s risk adjustment software and analytics to health plans, provider organizations, ACOs, MSOs, and other risk-bearing entities.
Risk adjustment is one of the highest-stakes and fastest-evolving areas in healthcare, where coding accuracy, documentation integrity, and audit readiness directly drive financial and compliance outcomes. You will sell to the leaders who own those outcomes (risk adjustment, coding, quality, finance, and compliance executives), and you will build credibility by understanding their priorities and engaging in meaningful business conversations rather than leading with product features.
This is a highly consultative, insight-led role that leverages Challenger-style selling principles. Reporting to the SVP of Sales & Growth and working alongside a peer group of BDEs, you will have dedicated support from marketing, sales development, and sales engineering. As MedInsight enters its next phase of growth, this is a high-visibility role with significant upside for career advancement.
Primary Responsibilities:
- Develop deep expertise in MedInsight’s risk adjustment software and analytics, and in the surrounding market (CMS-HCC models, RADV, quality programs, value-based care, and the competitive landscape) to engage prospects as a credible advisor.
- Build and execute a strategic national territory plan across health plans, provider organizations, ACOs, MSOs, and risk-bearing entities through targeted research, outbound prospecting, and insight-led engagement.
- Identify, develop, and rigorously qualify opportunities using a structured sales methodology, mapping decision-makers and influencers across executive, clinical, financial, operational, and compliance functions.
- Drive multi-threaded deal progression with stakeholders including C-suite executives, risk adjustment and coding/CDI leaders, quality and finance leaders, operations, and IT.
- Lead consultative conversations that surface explicit and unrecognized needs across RAF performance, coding accuracy, documentation integrity, audit readiness, provider engagement, and both retrospective and prospective risk adjustment.
- Deliver compelling commercial narratives that challenge the status quo and position MedInsight as a strategic solution for improving risk capture, compliance, operational efficiency, and reimbursement outcomes.
- Partner closely with Marketing on outbound opportunity creation, campaign follow-up, event engagement, and account-based prospecting.
- Collaborate with Sales Engineering, Product, Client Success, and Subject Matter Experts to deliver tailored demonstrations and ROI-driven business cases tied to measurable outcomes rather than features alone.
- Consistently achieve and exceed quota and pipeline-generation targets, and maintain accurate forecast, opportunity, account, and activity data in Salesforce to support disciplined territory management.
Preferred Skills and Experience:
- 8 or more years of full-cycle new-business development in complex, consultative enterprise sales, preferably in healthcare technology, analytics, SaaS, or payment integrity / risk adjustment solutions.
- Demonstrated success selling into healthcare payer, provider, and/or risk-bearing organizations, navigating complex buying groups and long sales cycles.
- Direct experience selling risk adjustment, coding, CDI, quality, value-based care, population health, or related analytics solutions is strongly preferred.
- Experience with the risk adjustment and reimbursement landscape (Medicare Advantage, ACA, Medicaid managed care, HCC coding, RAF optimization, RADV, and documentation/compliance) is strongly preferred.
- Proven track record of building pipelines from scratch and executing territory plans in greenfield, competitive, or underpenetrated markets.
- Demonstrated success negotiating and closing complex enterprise agreements with senior decision-makers, including CFOs, CIOs, COOs, CMOs, Chief Population Health Officers, and VP-level risk adjustment and compliance leaders.
- Skilled at partnering with Sales Engineering and cross-functional teams to deliver outcome-oriented demonstrations and solution positioning.
- Bachelor’s degree in business, healthcare administration, finance, economics, public health, or a related field preferred; advanced degree (MBA, MHA, MPH, or similar) a plus. Neither is required.
Key Competencies:
- Challenger Mindset: Leads with insight, teaches prospects something new about their risk adjustment performance, and creates urgency for change.
- Consultative Seller: Uncovers root business issues and ties solutions to measurable financial, compliance, and operational outcomes.
- Analytical & Strategic: Synthesizes market, financial, and operational data into sharp, customer-specific account strategies.
- Entrepreneurial: Resourceful and proactive; creates momentum, opens doors, and builds pipeline in ambiguous, evolving markets.
- Emotionally Intelligent: Builds trust quickly, navigates complex stakeholder dynamics, and turns feedback into growth.
- Intellectually Curious: Stays ahead of shifting regulations, reimbursement models, and emerging market opportunities.
- Effective Communication: A clear, confident, persuasive communicator in writing and in person, including at the executive level.
- Organized & Resilient: Manages multiple opportunities and internal partnerships with precision, follow-through, and persistence.
Location
This role can be remote within the U.S. The expected application deadline for this job is August 30, 2026.
Compensation
The overall salary range for this role is $104,900 - $199,065. For candidates residing in:
- Alaska, California, Connecticut, Illinois, Maryland, Massachusetts, New Jersey, New York City, Pennsylvania, Virginia, Washington, or the District of Columbia, the salary range is $120,635 - $199,065.
- All other locations the salary range is $104,900 - $173,100.
A combination of factors will be considered, including, but not limited to, education, relevant work experience, qualifications, skills, certifications, etc.
What makes this a great opportunity?
- Join an innovative, high growth company with a solid industry track record
- Bring your expertise and ideas to directly impact and help build the next generation of MedInsight products and solutions
- Be recognized for your contributions and impact
- Work for a company that values your wellbeing and professional growth, offering a flexible work environment, generous benefits package, and investment in the development of your career
Benefits
We offer a comprehensive benefits package designed to support employees’ health, financial security, and well-being. Benefits include:
- Medical, Dental and Vision – Coverage for employees, dependents, and domestic partners
- Employee Assistance Program (EAP) – Confidential support for personal and work-related challenges
- 401(k) Plan – Includes a company matching program and profit-sharing contributions.
- Discretionary Bonus Program – Recognizing employee contributions
- Flexible Spending Accounts (FSA) – Pre-tax savings for dependent care, transportation, and eligible medical expenses
- Paid Time Off (PTO) – Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis
- Holidays – A minimum of 10 paid holidays per year
- Family Building Benefits – Includes adoption and fertility assistance
- Paid Parental Leave – 11 weeks of paid leave for employees who meet eligibility criteria.
- Life Insurance & AD&D – 100% of premiums covered by Milliman
- Short-Term and Long-Term Disability – Fully paid by Milliman
Equal Opportunity
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, or status as a protected veteran.
#LI-REMOTE
#LI-SM1
#MedInsight
About Milliman
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Milliman delivers market-leading services and solutions to clients worldwide. Today, we are helping companies take on some of the world's most critical and complex issues, including retirement funding and healthcare financing, risk management and regulatory compliance, data analytics and business transformation.
Industry
Business management consulting and fitness and sports centers
Company size
1,001 - 5,000 Employees
Headquarters location
Seattle, WA, US