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Risk Adjustment Coder Jobs (NOW HIRING)

Regal Medical Group, Inc.

$25 - $27/hr

We are looking for HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing ...

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Risk Adjustment Coder information

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$15

$27

$43

How much do risk adjustment coder jobs pay per hour?

As of Jun 25, 2026, the average hourly pay for risk adjustment coder in the United States is $27.49, according to ZipRecruiter salary data. Most workers in this role earn between $18.99 and $34.62 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.

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, especially as value-based care models grow, and often requires certification and attention to detail. It can be a stable and rewarding career for those interested in medical coding and healthcare finance.

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 specialized training or certification in medical coding, such as the Certified Risk Adjustment Coder (CRC) credential. Experience with medical billing, coding software, and understanding of healthcare documentation are also important for this role.

What pays more, CCS or CPC?

As a Risk Adjustment Coder, earning potential depends on certification and experience. Generally, Certified Coding Specialist (CCS) coders tend to have higher salaries than Certified Professional Coder (CPC) coders due to the advanced skills and hospital setting focus, but salaries can vary based on location and employer. Both certifications require strong coding skills and knowledge of medical coding systems.

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 and documentation. Salaries can also vary based on employer size and work setting, such as hospitals or insurance companies.

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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Risk Adjustment Coder jobs near you
Infographic showing various Risk Adjustment Coder job openings in the United States as of June 2026, with employment types broken down into 88% Full Time, and 12% Part Time. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $57,182 per year, or $27.5 per hour.

HCC Risk Adjustment Coder, Sr.

Heritage Provider Network

West Hills, CA • On-site, Remote

$33 - $36/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 15 days ago

Job description

We are looking for experienced HCC Risk Adjustment Auditors/Coders , Sr. to join our team!

Position Summary:


The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services.

Essential Duties and Responsibilities include the following:

  • Works as an integral member of the Finance Department.
  • Code review super bills and patient medical records for proper use of diagnosis and procedure codes.
  • Interface effectively with physicians and office staff on coding issues. Research coding questions as needed.
  • Code review a wide variety of document types, i.e., Primary and specialty care medical records, mental health, substance abuse, in-patient, out-patient, non-submittals (lab), ancillary, and pharmaceutical services for HCC values.
  • Perform both provider office audits and online audits by reviewing patient medical records.
  • Provide education to the provider and staff on office audit findings. Communicate best coding practices.
  • Consistently meet productivity and quality standards as outlined by the supervisor.
  • Generate MS Excel spreadsheets for various projects with the primary focus on tracking activities.
  • Make internal and external phone calls to other departments and provider offices as needed.
  • Learn software programs essential to the HCC department, such as iCode, EZCap, and Access Express. Also, to learn the HCC model.
  • Upload medical records via our internal software program iCode.
  • Research and correspond with our providers to obtain correct diagnosis coding as generated from internal and external error reports.
  • Present educational material to providers.
  • Perform photocopy services.
  • Perform scanning services.
  • Perform faxing services.
  • All other duties as directed by management.

The pay range for this position at the commencement of employment is expected to be between $33 and $36 per hour, depending on experience. However, the base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.

The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.

Details of participation in these benefit plans will be provided to employees who receive an offer of employment.

If hired, the employee will be in an "at-will position," and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

As one of the fastest-growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming, and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

Full-Time Position Benefits:

The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.

Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.

Health and Wellness:

  • Employer-paid comprehensive medical, pharmacy, and dental for employees
  • Vision insurance
  • Zero co-payments for employed physician office visits
  • Flexible Spending Account (FSA)
  • Employer-Paid Life Insurance
  • Employee Assistance Program (EAP)
  • Behavioral Health Services

Savings and Retirement:

  • 401 (k)Retirement Savings Plan
  • Income Protection Insurance

Other Benefits:

  • Vacation Time
  • Company celebrations
  • Employee Assistance Program
  • Employee Referral Bonus
  • Tuition Reimbursement
  • License Renewal CEU Cost Reimbursement Program
  • Business-casual working environment
  • Sick days
  • Paid holidays
  • Mileage

Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

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