ZipRecruiter

Log In

1

Risk Adjustment Coder Jobs in Chicago, IL (NOW HIRING)

Bcbsa

Head of Medicare Performance Hub

Chicago, IL

CMS Star Ratings, Risk Adjustment/HCC coding accuracy, or Medical Cost Management (utilization management, care management, medical economics) * Proven experience managing complex, multi-stakeholder ...

Medix

Denials & Appeals Coder

Elmhurst, IL · On-site

$30 - $35/hr

Ensure all adjustments and appeals comply with regulations and accuracy standards. Qualifications * Expert-level understanding of E/M coding guidelines and updated Medical Decision Making framework.

Insight

Coder lll -Inpatient Coder

Chicago, IL · On-site

$31 - $36/hr

... Risk of Mortality (ROM) assignments for Inpatient records and accurate APC assignments and all ... Assigns appropriate code(s) by utilizing coding guidelines established by: * The Centers for ...

Insight

Coder lll -Inpatient Coder

Chicago, IL · Remote

$31 - $36/hr

Risk of Mortality (ROM) assignments for Inpatient records and accurate APC assignments and all ... Assigns appropriate code(s) by utilizing coding guidelines established by: * The Centers for ...

Medix

Coder

Skokie, IL · On-site

$26 - $38/hr

Perform coding audits to identify missed revenue and compliance risks. * Provide virtual coding education to physicians and practice managers. * Review clinical documentation and payer policies for ...

Wolcott Wood Taylor

PB Coder

Chicago, IL · On-site

PB Coder Chicago The PB Coder is responsible for reviewing, analyzing, and accurately coding ambulatory and/or hospital-based encounters. This role performs initial charge review for E/M visits ...

Rush University Medical Center

PB Coder

Chicago, IL · On-site

$27.47 - $43.27/hr

This position is responsible for overseeing the billing, coding guidelines and entire charge capture process for physicians including research charges for Rush University. This includes ...

Rush

PB Coder

Chicago, IL · On-site

$27.47 - $43.27/hr

This position is responsible for overseeing the billing, coding guidelines and entire charge capture process for physicians including research charges for Rush University. This includes ...

next page

Showing results 1-20

All JobsRisk Adjustment Coder JobsRisk Adjustment Coder Jobs in Chicago, IL

Risk Adjustment Coder information

See Chicago, IL salary details

$16

$28

$44

How much do risk adjustment coder jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for risk adjustment coder in Chicago, IL is $28.34, according to ZipRecruiter salary data. Most workers in this role earn between $19.57 and $35.67 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 Chicago, IL?

The most popular types of Risk Adjustment Coder jobs in Chicago, IL are:

What are popular job titles related to Risk Adjustment Coder jobs in Chicago, IL?

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

What job categories do people searching Risk Adjustment Coder jobs in Chicago, IL look for?

The top searched job categories for Risk Adjustment Coder jobs in Chicago, IL are:

What cities near Chicago, IL are hiring for Risk Adjustment Coder jobs?

Cities near Chicago, IL with the most Risk Adjustment Coder job openings:

Risk Adjustment Coder jobs near you
Infographic showing various Risk Adjustment Coder job openings in Chicago, IL as of August 2026, with employment types broken down into 1% As Needed, 87% Full Time, 9% Part Time, and 3% Contract. Highlights an 88% Physical, 5% Hybrid, and 7% Remote job distribution, with an average salary of $58,952 per year, or $28.3 per hour.

Senior Manager, Corporate Compliance - Risk Adjustment

CVS Health

Northbrook, IL

$75K - $165K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 22 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,333 frontline employees who took The Breakroom Quiz

89th of 112 rated pharmacies

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.

The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.

Key Responsibilities

  • Lead the Medicare Advantage Risk Adjustment compliance program.

  • Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.

  • Assess operational processes for compliance risks related to risk adjustment activities.

  • Develop and implement corrective action plans for identified compliance issues.

  • Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.


Required Qualifications

  • Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance

  • Minimum 5 years in a leadership role

  • One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)

  • Willingness to travel up to 10% (including by plane)


Preferred Qualifications

  • Health Information Management (RHIA/RHIT)

  • Nursing - Strong understanding of clinical documentation and medical record review

  • Certified Risk Adjustment Coder (CRC) with compliance experience

  • Provider coding audit/compliance leadership experience

  • Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits


Education

Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.

Pay Range

The typical pay range for this role is:

$75,400.00 - $165,954.00


This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/12/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

What CVS Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply