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Risk Adjustment Coding Manager Jobs in Rochester, NY

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Risk Adjustment Coding Manager information

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How much do risk adjustment coding manager jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for risk adjustment coding manager in Rochester, NY is $32.58, according to ZipRecruiter salary data. Most workers in this role earn between $24.66 and $39.38 per hour, depending on experience, location, and employer.

What is a risk adjustment coding manager?

Risk Adjustment Coding Managers are professionals responsible for overseeing the medical coding process related to risk adjustment in healthcare organizations. They ensure accurate coding of diagnoses and procedures to reflect the health status of patients, which is essential for proper reimbursement from Medicare Advantage and other insurance plans. These managers lead teams of coders, maintain compliance with regulations, and implement quality assurance processes to optimize coding accuracy and organizational performance.

What are the key skills and qualifications needed to thrive as a risk adjustment coding manager?

To thrive as a Risk Adjustment Coding Manager, you need expertise in medical coding (CPT, ICD-10), risk adjustment methodologies, and a background in healthcare management, often supported by a coding certification such as CPC, CRC, or CCS. Familiarity with coding software, EHR systems, and data analytics tools is typically required. Strong leadership, attention to detail, and the ability to communicate compliance standards effectively are crucial soft skills. These skills ensure accurate risk adjustment coding, regulatory compliance, and improved financial outcomes for healthcare organizations.

What are some common challenges faced by risk adjustment coding managers, and how can they effectively address them?

Risk Adjustment Coding Managers often encounter challenges such as ensuring coding accuracy, keeping up with regulatory changes, and coordinating across multidisciplinary teams. To address these, effective managers implement rigorous quality assurance processes, provide ongoing coder education, and maintain open communication with clinical, compliance, and data analytics teams. Staying updated on CMS guidelines and fostering a culture of continuous improvement are also key strategies for success in this role.

What is the difference between Risk Adjustment Coding Manager vs Risk Adjustment Coder?

AspectRisk Adjustment Coding ManagerRisk Adjustment Coder
CertificationsAHIMA or AAPC credentials, management experienceAHIMA or AAPC credentials, coding certification
Work EnvironmentSupervisory role, overseeing coding teamsPerforming coding tasks directly on patient records
Employer & IndustryHealth plans, healthcare providers, insurance companiesHospitals, clinics, health plans

The Risk Adjustment Coding Manager oversees coding teams and ensures compliance, while the Risk Adjustment Coder focuses on accurately coding patient records. Both roles require similar certifications but differ in responsibilities and work environment, with managers handling supervision and coders performing detailed coding tasks.

What are the most commonly searched types of Risk Adjustment Coding jobs in Rochester, NY?

The most popular types of Risk Adjustment Coding jobs in Rochester, NY are:

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For Risk Adjustment Coding Manager jobs in Rochester, NY, the most frequently searched job titles are:

What job categories do people searching Risk Adjustment Coding Manager jobs in Rochester, NY look for?

The top searched job categories for Risk Adjustment Coding Manager jobs in Rochester, NY are:

What cities near Rochester, NY are hiring for Risk Adjustment Coding Manager jobs?

Cities near Rochester, NY with the most Risk Adjustment Coding Manager job openings:

Risk Adjustment Coding Manager jobs near you
Infographic showing various Risk Adjustment Coding Manager job openings in Rochester, NY as of August 2026, with employment types broken down into 89% Full Time, 10% Part Time, and 1% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $67,768 per year, or $32.6 per hour.

Risk Adjustment Quality Specialist

100 Lawrence Memorial Hospital

Rochester, NY • On-site

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Job Summary

The Risk Adjustment Quality Specialist coordinates and supports prospective, concurrent, and retrospective reviews to assist with patient care management. The role provides education and facilitates chart retrieval for Health Plan audits and reports. It requires a comprehensive understanding of Hierarchical Condition Categories (HCC) coding to accurately translate, input, extract, and validate medical record data.

The specialist assists with monitoring quality program performance, including tracking, reporting, and implementation of best practices and program requirements. Essential Job Responsibilities Perform comprehensive reviews of patient medical records to assess documentation consistency and adequacy, identifying appropriate coding based on CMS HCC categories. Monitor revenue opportunities related to value‐based care.

Manage the provider query process to clarify documentation and ensure completeness and accuracy of patient diagnoses, especially for chronic conditions. Use evidence‐based practices to provide providers with targeted feedback and education on improving documentation and coding accuracy related to HCC. Demonstrate analytical and problem‐solving ability to address barriers in receiving and validating accurate HCC information. Analyze performance data to identify trends, gaps, and opportunities for improvement.

Maintain an intermediate to advanced understanding of claims processing procedures, state and federal regulations, and Medicare Part D requirements. Utilize coding software to ensure compliance with Medicare, Medicaid, and other payer requirements. Collaborate with medical staff to clarify documentation and support accurate coding and reimbursement. Participate in audits, quality reviews and continuous‐improvement initiatives. Educate staff on coding practices and HCC assignments.

Maintain compliance with policies, procedures, and continuing‐education requirements. Perform additional duties as needed or assigned. Job Qualifications Minimum 3 years of experience in medical coding or risk adjustment with a focus on Hierarchical Condition Categories, value‐based care contracts, and accountable care organizations. Strong knowledge of CMS risk‐adjustment and quality initiatives, including HCCs.

Completion of an AHIMA accredited certificate program (e.g., Certificate Coding Associate, Certificate Coding Specialist, Certified Professional Coder, Registered Health Information Technician, Registered Health Information Administrator) or credential from AAPC.

Preferred:

Registered Nurse Associate or Bachelor's Degree in Health Information Management. Experience with 3M Coding Solution knowledge. Hybrid work flexibility: must reside in Kansas or Missouri and attend on‐site meetings as scheduled.

Benefits

Competitive pay and advancement potential. Tuition reimbursement to support continuing education. Professional development and recognition. Excellent benefits package. We are an equal‐opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

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