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Risk Adjustment Coder Jobs in Delaware (NOW HIRING)

Phpmcs

$200 - $220/hr

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

ChristianaCare

Coder III - Remote

Newark, DE · On-site +1

Performs coding and abstracting tasks to support accurate and timely billing, data quality and statistics, and calculation of severity of illness and risk of mortality reporting. * Follows UHDDS ...

Bayhealth

Coder

Dover, DE · On-site

$18.75 - $25/hr

Works with coding databases and confirms DRG assignments. Responsibilities: 1. Codes data from patient records utilizing computerized coding systems to ensure optimal reimbursement of the hospital.

TidalHealth

Inpatient Coder

Seaford, DE · On-site

$26.92 - $41.72/hr

Inpatient Coder Position Summary The Hospital Inpatient Coder accurately abstracts pertinent information from the patient record to apply the appropriate diagnostic and procedural codes to individual ...

TidalHealth

Inpatient Coder

Seaford, DE · On-site

$26.92 - $41.72/hr

Inpatient Coder Position Summary The Hospital Inpatient Coder accurately abstracts pertinent information from the patient record to apply the appropriate diagnostic and procedural codes to individual ...

TidalHealth

Coder-Outpatient

Seaford, DE · On-site

$24.41 - $37.84/hr

Coder-Outpatient Position Summary The Hospital Outpatient Coder accurately abstracts pertinent information from the patient record to apply the appropriate diagnostic and procedural codes to ...

Bayhealth

Certified Coder

Dover, DE · On-site

$22.75 - $30.25/hr

Works with coding databases and confirms DRG assignments. Responsibilities: 1. Codes data from patient records utilizing computerized coding systems to ensure optimal reimbursement of the hospital.

Compunnel, Inc.

Medical Coder - Profee Coders

Dover, DE · On-site

$41/hr

Code E/M services, surgeries, injections, and infusions. Maintain productivity of 120-150 charts per day. Adapt quickly to varying specialties as needed.B Review documentation using EPIC. Utilize ...

M&T Bank

Senior Application Security Engineer

Wilmington, DE · On-site

$57 - $76.25/hr

Partner with engineering teams during code reviews to identify potential security vulnerabilities ... Identify risk-related issues needing escalation to management. * Promote an environment that ...

M&T Bank

Senior Application Security Engineer

Wilmington, DE · On-site

$57 - $76.25/hr

Partner with engineering teams during code reviews to identify potential security vulnerabilities ... Identify risk-related issues needing escalation to management. * Promote an environment that ...

Liquid Personnel

Respond to referrals and complete timely risk assessments * Liaise with families, schools, and ... Reasonable Adjustments: If you consider yourself to have a disability or require any reasonable ...

Liquid Personnel

Conduct initial assessments to determine risk levels and service eligibility. * Make decisions on ... Reasonable Adjustments: If you consider yourself to have a disability or require any reasonable ...

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All JobsRisk Adjustment Coder JobsRisk Adjustment Coder Jobs in Delaware

Risk Adjustment Coder information

See Delaware salary details

$15

$27

$43

How much do risk adjustment coder jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for risk adjustment coder in Delaware is $27.51, according to ZipRecruiter salary data. Most workers in this role earn between $18.99 and $34.66 per hour, depending on experience, location, and employer.

What do risk adjustment coders do?

Risk adjustment coders review medical records and assign accurate diagnosis codes to reflect patients' health conditions. Their work helps insurance companies and healthcare organizations assess risk and determine appropriate reimbursements, often using coding systems like ICD-10. Attention to detail and knowledge of coding guidelines are essential for accuracy in this role.

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.

Is HCC coding a good career?

Risk adjustment coders specializing in Hierarchical Condition Category (HCC) coding play a vital role in healthcare reimbursement and risk management. The field offers steady demand, opportunities for certification, and potential for career advancement, especially for those with strong attention to detail and knowledge of medical coding and billing systems.

What are Risk Adjustment Coders?

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.

How to become a risk adjustment coder?

To become a risk adjustment coder, typically one needs a high school diploma or equivalent, followed by completing a coding certification program such as Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC). Experience with medical coding, understanding of healthcare documentation, and proficiency in coding software are also important for this role.

What pays more, CCS or CPC?

As a Risk Adjustment Coder, CPC (Certified Professional Coder) typically offers higher pay than CCS (Certified Coding Specialist) because CPCs are often more versatile and in demand across various healthcare settings. However, salaries can vary based on experience, certification, and geographic location. Both certifications are valuable, but CPCs generally have higher earning potential in the coding field.

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 are popular job titles related to Risk Adjustment Coder jobs in Delaware? For Risk Adjustment Coder jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Risk Adjustment Coder jobs in Delaware look for? The top searched job categories for Risk Adjustment Coder jobs in Delaware are:
Risk Adjustment Coder jobs near you
Infographic showing various Risk Adjustment Coder job openings in Delaware as of July 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $57,231 per year, or $27.5 per hour.
Certified Professional Coder

Certified Professional Coder

Regional Medical Management Services LLC

Wilmington, DE • On-site

$22 - $28/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 24 days ago

Job description

  • Position Summary

    • The Certified Orthopedic Coder is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes for orthopedic-related diagnoses, procedures, and services. This role requires deep knowledge of musculoskeletal anatomy, surgical techniques, and orthopedic subspecialties to ensure compliant coding, optimal reimbursement, and adherence to payer and regulatory guidelines. The coder works closely with physicians, clinical staff, and billing teams to support clean claims, audit readiness, and revenue integrity.

  • Key Responsibilities
  • Coding & Documentation
  • Assign accurate ICD10CM, CPT, and HCPCS codes for orthopedic outpatient, inpatient, and surgical services
  • Code complex orthopedic procedures including:

    • ~Joint replacements

    ~Arthroscopy

    ~Spine procedures

    ~Fracture care

    ~Sports medicine procedures

  • Ensure coding reflects correct laterality, encounter type, global periods, and modifiers (e.g., 26, TC, 50, 59, LT/RT)
  • Compliance & Quality
  • Maintain compliance with CMS, AMA, payerspecific, and regulatory coding guidelines
  • Participate in internal and external audits; address findings and implement corrective actions
  • Stay current with annual coding updates, NCCI edits, LCDs/NCDs, and orthopedic coding trends
  • Identify documentation gaps and proactively query providers when clarification is needed
  • Collaboration & Support
  • Work closely with orthopedic surgeons, APPs, and clinical teams to improve documentation quality
  • Support billing and denial management teams by providing coding clarification and appeal support
  • Contribute to process improvement initiatives focused on accuracy, efficiency, and compliance
  • Productivity & Reporting
  • Meet or exceed established productivity and accuracy benchmarks
  • Track and report coding issues, trends, and opportunities for improvement
  • Assist with onboarding and mentoring junior coders as needed
  • Required Qualifications
  • Education & Certification

    • ~High school diploma or equivalent required

    ~Active coding certification, such as:

    CPC (AAPC)

    CCS (AHIMA)

    ~Orthopedic coding specialty certification preferred (e.g., COSC)

  • Experience

    • ~Minimum 2–3 years of orthopedic-specific coding experience

    ~Demonstrated experience coding operative reports and complex orthopedic cases

    ~Experience with EHR and practice management systems

  • Preferred Qualifications

    • ~Experience in high-volume orthopedic or multispecialty practices

    ~Knowledge of both professional and facility coding

    ~Prior audit or compliance experience

    ~Familiarity with value-based care and risk adjustment principles

  • Skills & Competencies

    • ~Advanced knowledge of musculoskeletal anatomy and orthopedic procedures

    ~Strong attention to detail with high accuracy standards

    ~Analytical mindset with the ability to interpret complex clinical documentation

    ~Excellent written and verbal communication skills

    ~Ability to work independently while collaborating across departments

    ~Strong time management and organizational skills

  • Work Environment
  • Officebased
  • Prolonged periods of computerbased work
  • Fastpaced, deadlinedriven environment requiring sustained accuracy
  • Performance Metrics
  • Coding accuracy rate
  • Productivity benchmarks
  • Audit outcomes
  • Denial reduction and clean claim rates
  • Benefits
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Dependent care flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

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