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Risk Adjustment Coder Jobs in Ohio (NOW HIRING)

Premier Health

PHYSICIAN ADVISOR

Dayton, OH · On-site

This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...

Premier Health

PHYSICIAN ADVISOR

Dayton, OH · On-site

This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...

Premier Health

PHYSICIAN ADVISOR

Dayton, OH · On-site

This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...

Premier Health

PHYSICIAN ADVISOR

Dayton, OH · On-site

This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...

Premier Health

PHYSICIAN ADVISOR

Dayton, OH · On-site

This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams. The Physician Advisor ...

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Showing results 1-20

All JobsRisk Adjustment Coder JobsRisk Adjustment Coder Jobs in Ohio

Risk Adjustment Coder information

See Ohio salary details

$15

$26

$41

How much do risk adjustment coder jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for risk adjustment coder in Ohio is $26.14, according to ZipRecruiter salary data. Most workers in this role earn between $18.08 and $32.88 per hour, depending on experience, location, and employer.

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.

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.
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What cities in Ohio are hiring for Risk Adjustment Coder jobs? Cities in Ohio with the most Risk Adjustment Coder job openings:
Risk Adjustment Coder jobs near you
Infographic showing various Risk Adjustment Coder job openings in Ohio as of August 2026, with employment types broken down into 97% Full Time, and 3% Contract. Highlights an 73% In-person, 6% Hybrid, and 21% Remote job distribution, with an average salary of $54,363 per year, or $26.1 per hour.

Manager Clinical Performance & Quality Coding (Nurse Practitioner or PA)

Elevance Health

Mason, OH • On-site

Other

Posted 4 days ago

Elevance Health rating

7.7

Company rating: 7.7 out of 10

Based on 349 frontline employees who took The Breakroom Quiz

200th of 304 rated insurance

Job description

Manager Clinical Performance & Quality (Nurse Practitioner/Physician Assistant)

Manager Clinical Performance & Quality Coding

LOCATION: The position requires that you be in the office 3x per week. You must be within a commutable distance of one of our eligible offices.

HOURS: General business hours, Monday through Friday (8-5 central)

Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Responsible for leading the quality documentation and value capture for all provider visit medical encounters to ensure application of accurate diagnosis codes (ICD-10 codes).

Primary duties include but not limited to:

  • Serves as the primary resource and subject matter expert on all CMS Risk Adjustment and quality documentation.
  • Develop and deliver clinical focused training on advance coding and documentation while incorporating coder feedback.
  • Liaison to the clinical leadership on alignment of goals and workflows to support value capture initiatives and high-quality clinical documentation.
  • Develop performance management plan, KPI's and clinical level tracking to meet quarterly goals for coding timeliness, accuracy, and Risk Adjustment.
  • Develop and manage clinical quality reviews to ensure peer review and clinical quality chart audit process including targeting chart reviews, auditing percentages, score guidelines feedback mechanism and ensure compliance with remediation procedures.
  • Develop operational and clinical workflows for closing HEDIS care opportunities to ensure practices and health plan success.
  • Participate in peer review of medical documentation for completed visits notes as well as patient profile information in EMR.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Required Qualifications

  • Current, active, valid, and unrestricted nurse practitioner (NP) or PA license in applicable state(s) required.
  • Requires a master's in Nursing (or PA equivalent) and at least 3 years of clinical experience in applying appropriate diagnosis in the Medicare HCC Mode; or any combination of education and experience, which would provide an equivalent background.
  • Requires experience with CMS Risk Models.

Preferred Qualifications

  • You must have previous management/supervisory experience with direct reports.
  • HEDIS experience is preferred.
  • Experience with clinical data/documentation integrity is preferred (CDEO or CDEI).
  • Prefer AAPC Certified Risk Adjustment Coder (CRC) certification.

Job Level: Manager

Workshift: 1st Shift (United States of America)

Job Family: MED > Licensed Nurse

What Elevance Health employees say

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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

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