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Risk Adjustment Coder Jobs in Colorado (NOW HIRING)

Phpmcs

Physician - Primary Care

Denver, CO · On-site

$200 - $250/hr

PHPprime provides wrap-around services to help make our practice successful, including care coordination, practice transformation coaching, risk adjustment coding education, population health ...

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All JobsRisk Adjustment Coder JobsRisk Adjustment Coder Jobs in Colorado

Risk Adjustment Coder information

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$16

$28

$45

How much do risk adjustment coder jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for risk adjustment coder in Colorado is $28.91, according to ZipRecruiter salary data. Most workers in this role earn between $19.95 and $36.39 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 popular job titles related to Risk Adjustment Coder jobs in Colorado?

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

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

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

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

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

Risk Adjustment Coder jobs near you
Infographic showing various Risk Adjustment Coder job openings in Colorado as of August 2026, with employment types broken down into 71% Full Time, 18% Part Time, and 11% Contract. Highlights an 77% In-person, and 23% Remote job distribution, with an average salary of $60,128 per year, or $28.9 per hour.

Program Manager, Risk Adjustment & Stars

Phpmcs

Denver, CO • On-site

$84 - $120/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted yesterday

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Job description

Are you looking to work for a company that has been recognized for over a decade as a Top Place to Work? Apply today to become a part of a company that continues to commit to putting our employees first.

OVERVIEW OF POSITION

The Program Manager, Risk Adjustment & Stars, serves as the connective link between Alpine's technical teams (coding, data, analytics, IT) and its operational and business stakeholders (leadership, quality, health plan operations) for risk adjustment and Star Ratings performance. This role translates technical details, such as data pipelines, coding logic, and CMS methodology, into operational plans, priorities, and decisions, while ensuring operational requirements and business goals are reflected back into the technical work. The role does not require direct provider-facing engagement.

ESSENTIAL DUTIES
  • Program Management Owns the annual risk adjustment and Stars improvement program cycle, coordinating between technical teams and operational/business stakeholders across prospective and retrospective programs, visit-based campaigns, and gap closure workflows.
  • Builds and manages program timelines and throughput; reports progress to Alpine leadership and health plan partners in clear, business-friendly terms.
  • Leads cross-functional workgroups spanning coding/HCC teams, clinical quality, IT, and analytics, ensuring technical work stays aligned to operational priorities.
  • Manages program-level documentation and requirements, translating between technical specifications and operational plans.
  • Risk Adjustment Acts as the liaison between coding/data teams and operational stakeholders on HCC capture workflows, chart review pipelines, and gap identification, ensuring both sides understand priorities and constraints.
  • Manages relationships with vendors, coordinating technical file exchange and integration needs with operational timelines and expectations.
  • Monitors RAF score trends and performance results, working with analytics teams to interpret findings and translates them into operational action plans.
  • Coordinates risk adjustment data submission accuracy and reconciliation (EDS), connecting technical issue resolution with business and health plan deadlines.
  • Tracks HCC model version transitions (e.g., CMS-HCC V24/V28) and communicates their operational and financial impact to leadership and business teams.
  • Stars & Quality Coordinates Alpine's Star Ratings strategy across HEDIS, CAHPS, HOS, and medication adherence measures, connecting technical measure logic with operational execution.
  • Partners with analytics teams to maintain measure-level performance tracking and cut-point modeling, translating results into operational priorities and gap closure plans.
  • Serves as one point of contact for Alpine with health plan Stars/quality teams, bridging technical data exchange requirements with operational and contractual needs.
  • Analytics & Reporting Partners with analytics and data teams to define KPIs and dashboards for RAF accuracy, coding gap closure rates, and Star measure performance, ensuring outputs are operationally useful.
  • Translates CMS methodology updates (HCC model version changes, Star Ratings technical notes, measure weighting changes) for both technical teams (as specifications) and operational teams (as business impact).
  • Helps identify and escape data integrity issues across source systems (claims, EHR, supplemental data feeds), coordinating resolution between technical and operational owners.
  • Presents performance results and program recommendations to Alpine executive leadership and payer partners.
  • Compliance & Governance Ensures all program activities comply with CMS regulations, ICD-10-CM coding guidelines, and Alpine's compliance policies. Supports RADV audit readiness and health plan data validation requests, coordinating between technical teams pulling data and operational/compliance teams managing the response.
EDUCATION

Bachelor's degree in health informatics, data analytics, healthcare administration, business, or related field (Master's preferred).

EXPERIENCE

Five (5) to seven (7) years of experience in Medicare Advantage risk adjustment and/or Star Ratings/quality improvement, ideally within a value-based care (VBC) setting.

PREFERRED QUALIFICATIONS
  • Certified Risk Adjustment Coder (CRC) credential.
  • Experience with value-based care, ACOs, or delegated risk arrangements.
  • Familiarity with multiple health plan Stars/quality programs and data exchange requirements.
  • PMP or similar certification.
KNOWLEDGE, SKILLS, ABILITIES

Working knowledge of CMS HCC risk adjustment models, RAF score methodology, EDS submission processes, and Star Ratings measure specifications. Demonstrated ability to work effectively with both technical teams (data, analytics, IT) and operational/business stakeholders, translating between the two. Proven program/project management experience managing cross-functional initiatives involving both technical and operational workstreams. Working proficiency in Excel required; familiarity with SQL, Tableau, Power BI, or similar tools a put a plus. Strong written and verbal communication skills, with the ability to translate technical and regulatory detail for operational and executive audiences. Skilled at translating between technical and operational audiences, comfortable in both worlds without needing to be a deep technical expert. Strong relationship management and cross-functional collaboration skills. Analytical and detail-oriented, able to interpret data and technical findings and turn them into operational plans. Adaptable to evolving CMS methodology and health plan requirements. Able to travel to meetings Ability to handle multiple demands concurrently in a high stress environment; organize, coordinate, set priorities and meet deadlines Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures

COMPENSATION AND BENEFITS
  • Salary Range: Salary Range: $83,990.40-$119,974.40
  • Additional Compensation: Eligible for annual bonus based on individual and/or company performance.
  • Benefits: Includes medical, dental, and vision insurance; 401(k); paid time off (PTO); and Employee Assistance Program (EAP)

Application Deadline: Open until filled. Applications will be reviewed on a rolling basis.

Alpine is growing, and we welcome new talent to our highly collaborative and diverse team. We are passionate about building a leading national organization that enables physicians to focus on the joy of practicing medicine, and supports the ongoing transition to value-based care for senior populations. Alpine brings this same level of passion to employee engagement, career development and progression. If this aligns with your career goals, then look no further. Grow with us!

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