ZipRecruiter

Log In

1

Risk Adjustment Coder Jobs in Wisconsin (NOW HIRING)

ThedaCare

Coder (Clinic - III)

Neenah, WI · On-site

$19.25 - $25.75/hr

Reviews and/or assigns proper CPT procedures and/or diagnosis codes (ICD-10-CM including HCC risk adjustment diagnosis) for professional services including specialty medical services, in and ...

ThedaCare

Coder (Clinic - III)

Neenah, WI · On-site

$19.25 - $25.75/hr

Reviews and/or assigns proper CPT procedures and/or diagnosis codes (ICD-10-CM including HCC risk adjustment diagnosis) for professional services including specialty medical services, in and ...

Urrly

Telehealth Nurse Practitioner

Madison, WI · Remote

$600 - $720/day

Document risk adjustment (HCC coding) during patient visits * Close HEDIS care gaps during visits * Review medical history, medications, and preventive needs * Document visits using ICD-10 and CPT II ...

next page

Showing results 1-20

All JobsRisk Adjustment Coder JobsRisk Adjustment Coder Jobs in Wisconsin

Risk Adjustment Coder information

See Wisconsin salary details

$16

$27

$43

How much do risk adjustment coder jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for risk adjustment coder in Wisconsin is $27.75, according to ZipRecruiter salary data. Most workers in this role earn between $19.18 and $34.95 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.
What are the most commonly searched types of Risk Adjustment Coder jobs in Wisconsin? The most popular types of Risk Adjustment Coder jobs in Wisconsin are:
What are popular job titles related to Risk Adjustment Coder jobs in Wisconsin? For Risk Adjustment Coder jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Risk Adjustment Coder jobs in Wisconsin look for? The top searched job categories for Risk Adjustment Coder jobs in Wisconsin are:
Risk Adjustment Coder jobs near you
Infographic showing various Risk Adjustment Coder job openings in Wisconsin as of August 2026, with employment types broken down into 86% Full Time, 10% Part Time, and 4% Contract. Highlights an 80% In-person, and 20% Remote job distribution, with an average salary of $57,717 per year, or $27.7 per hour.

Revenue Management Educator - Health Plan

Sanford Health

Marshfield, WI • On-site, Remote

Full-time

Re-posted 15 days ago

Sanford Health rating

6.8

Company rating: 6.8 out of 10

Based on 544 frontline employees who took The Breakroom Quiz

491st of 887 rated healthcare providers

Job description

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland.
Work Shift:
Day (United States of America)
Scheduled Weekly Hours:
40
Compensation:
Salary Range: $26.00 - $41.50
Union Position:
No
Department Details
Summary
The Revenue Management Educator is accountable for the successful development, implementation and delivery of educational and training resource materials to assist providers in coding accuracy. The Educator develops and implements strategic action, quality improvement and risk management plans. The Educator provides overall educational support and coding quality assurance activities to both internal and external stakeholders as it relates to Medicare Advantage, ACA/Exchange and Medicaid risk adjustment reimbursement methodologies and policies to ensure the accuracy and integrity of risk adjustment data submitted to the Centers for Medicare & Medicaid Services (CMS) and the Department of Health Services (DHS).
Job Description
Develops educational materials for providers in relation to diagnostic coding and risk adjustment revenue management to educate providers on thorough documentation and accurate coding. Identifies inadequate or erroneous documentation and/or coding to determine process improvement and educational opportunities.
Research's appropriate material (terminology, testing, abbreviations) to accurately assess documentation.
Analyzes coding and documentation to make appropriate judgments based on coding/ guidelines and policies. Monitors and audit performance in areas of compliance risk ensuring that established policies and procedures are being followed. Identifies the root cause of any errors to determine process improvement opportunities that may result in training, reference material revisions, and process changes. Assists in audits as it related to risk adjustment revenue management to address clinical issues related to documentation and coding. Assesses health insurance products, compliance, or operational risks and develop risk management strategies to improve revenue and reduce audit risk. Reviews, interprets and disseminates information relating to pending industry changes, trends and best practices to include CMS and DHS guidelines related to revenue management to anticipate necessary audits and education for providers.
Qualifications
Bachelor's degree required with an emphasis in a business or medical field, or a registered nurse degree. Completion of courses in Current Procedural Terminology (CPT), and ICD-9, ICD-10 and Hierarchical Condition Category (HCC) coding required
Will consider years of experience in lieu of bachelor's degree.
Three years' experience required in a health insurance, nursing, compliance, or auditing related position. Knowledge of CPT coding rules, ICD-9 and ICD-10 codes, Healthcare Common Procedure Coding System (HCPCS) codes, HCC coding, use of modifiers, documentation guidelines, CMS Policy requirements, and other reimbursement guidelines. Demonstrated knowledge of anatomy/physiology, medical terminology, Word, Excel, Power Point and Access.
Adult education/training and curriculum development preferred.
Certified Professional Coder certification awarded by American Academy of Professional Coders required within one year required. State of Wisconsin Registered Nurse license (if applicable).
Certified Risk Adjustment Coder awarded by American Academy of Professional Coders preferred.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-949-5678 or send an email to talent@sanfordhealth.org.

What Sanford Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Sanford Health logo

About Sanford Health

Sourced by ZipRecruiter

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Industry

Health care and social assistance and hospitals

Company size

10,000+ Employees

Headquarters location

Sioux Falls, SD, US

Social media

FacebookTwitter

View All Sanford Health Jobs

Apply