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Risk Adjustment Coder Jobs in Atlanta, GA (NOW HIRING)

Practice Success Partner

Atlanta, GA · On-site

$90 - $120/hr

Experience with HEDIS/Stars quality programs or risk adjustment coding processes (from a coordination standpoint, not chart-level execution). * Bachelor's degree or equivalent experience.

Practice Success Partner

Atlanta, GA · On-site

$120K - $145K/yr

... Risk Adjustment teams, who set strategy and targets; flag practice-level gaps to them and drive practice adoption of the resulting action items. Does not perform chart review, coding audits, or other ...

Practice Success Partner

Atlanta, GA · Remote

$120K - $145K/yr

... Risk Adjustment teams, who set strategy and targets; flag practice-level gaps to them and drive practice adoption of the resulting action items. Does not perform chart review, coding audits, or other ...

Telehealth Nurse Practitioner

Atlanta, GA · On-site +1

$600 - $720/day

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

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

... coding accuracy, and provider documentation practices. The analyst plays a key role in driving improvements in Case Mix Index (CMI), risk adjustment, and departmental performance by identifying ...

... coding accuracy, and provider documentation practices. The analyst plays a key role in driving improvements in Case Mix Index (CMI), risk adjustment, and departmental performance by identifying ...

... coding accuracy, and provider documentation practices. The analyst plays a key role in driving improvements in Case Mix Index (CMI), risk adjustment, and departmental performance by identifying ...

... coding accuracy, and provider documentation practices. The analyst plays a key role in driving improvements in Case Mix Index (CMI), risk adjustment, and departmental performance by identifying ...

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Risk Adjustment Coder information

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How much do risk adjustment coder jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for risk adjustment coder in Atlanta, GA is $26.44, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $33.27 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 Atlanta, GA?

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

What job categories do people searching Risk Adjustment Coder jobs in Atlanta, GA look for?

The top searched job categories for Risk Adjustment Coder jobs in Atlanta, GA are:

What cities near Atlanta, GA are hiring for Risk Adjustment Coder jobs?

Cities near Atlanta, GA with the most Risk Adjustment Coder job openings:

Infographic showing various Risk Adjustment Coder job openings in Atlanta, GA as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 12% Part Time, 2% Contract, and 1% Nights. Highlights an 84% Physical, 5% Hybrid, and 11% Remote job distribution, with an average salary of $54,989 per year, or $26.4 per hour.

Business Analyst with Risk Adjustment (Payor) || 1099 only || Need USC or GC only

Pantar Solutions inc

Atlanta, GA • On-site

Contractor

Re-posted yesterday


Job description

We are an Information Technology and Business Consulting firm specializing in Project-based Solutions and Professional Staffing Services. Please have a look at below position which is with our Client and let me know your interest ASAP. I would really appreciate if you could send me your MOST RECENT UPDATED RESUME

Title: Business Analyst – Risk Adjustment (Payor)

Location: Richmond or Atlanta  – Hybrid role

Long Term Contract || 1099 only || Need USC or GC only

Need strong Business Analyst – Risk Adjustment (Payor) with  risk adjustment analytics in a healthcare payer environment (Medicare Advantage, ACA (HIX/Exchange), or Medicaid), SQL, Excel, data visualization tools (Tableau/Power BI/SAS), healthcare data formats (claims, encounters, EMR, lab, and eligibility), regulatory processes (CMS, HHS, EDGE server, RADV/IVA audits), HCC coding models (CMS-HCC, HHS-HCC), ICD-10 codes, and claims data Exp.

Consultant LinkedIn profile must have been created before 2018/2019

Need 8-10+yrs of IT Exp. Profiles

Job Summary:Client is seeking a highly analytical and motivated Business Analyst – Risk Adjustment to support risk adjustment operations and data analytics initiatives. This role is critical in helping ensure accurate and compliant capture of risk adjustment data for government-sponsored programs such as Medicare Advantage and ACA (HIX/Exchange). The candidate will play a key role in translating business needs into technical solutions, driving insights, and enabling optimized risk scoring strategies.
Key Responsibilities:
  • Analyze and interpret risk adjustment data (claims, encounters, chart reviews, HCCs) to identify trends, data quality issues, and improvement opportunities.

  • Collaborate with stakeholders across actuarial, clinical coding, IT, and compliance teams to support risk score accuracy.

  • Translate regulatory and business requirements into user stories or functional specifications for data/reporting solutions.

  • Support CMS/HHS risk adjustment submission processes including EDGE server management and encounter reconciliation.

  • Assist in development and enhancement of dashboards/reports for risk score monitoring, suspecting models, and provider performance.

  • Monitor and interpret changes in CMS/HHS risk adjustment guidelines and apply to internal business processes.

  • Participate in audit support (e.g., RADV, IVA) and validation of risk adjustment data submissions.

  • Act as liaison between technical teams and business stakeholders to ensure delivery of actionable and scalable solutions.


Qualifications:
  • Bachelor's degree in Healthcare Administration, Business, Analytics, or related field (Master’s preferred).

  • 8+ years of experience in risk adjustment analytics in a healthcare payer environment (Medicare Advantage, Medicaid, or ACA).

  • Strong knowledge of HCC models (CMS-HCC, HHS-HCC), ICD-10 coding, and risk adjustment methodologies.

  • Experience with healthcare data formats: claims, encounters, EMR, lab, and eligibility.

  • Proficiency in SQL and Excel; experience with BI tools like Power BI, Tableau, or SAS preferred.

  • Familiarity with regulatory processes (CMS, HHS, EDGE server, RADV/IVA audits).


Preferred Skills:
  • Knowledge of data and reporting tools, including Cognos or Watson Health platforms.

  • Experience in Agile environments; ability to write and manage JIRA user stories and tasks.

  • Strong communication and stakeholder engagement skills across technical and business teams.

 
Thanks & Regards,
 
Babu