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Risk Adjustment Coding Manager Jobs (NOW HIRING)

Manage RADV audit preparation and response processes. * Collaborate with clinical, coding, and compliance teams to improve documentation and coding for risk adjustment purposes. Qualifications Must ...

The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare ...

Risk Adjustment Coder II

Houston, TX · On-site

$27.69 - $34.61/hr

... coding guidelines for Commercial and Medicare risk adjustment programs. Conduct thorough clinical documentation review to ensure sufficient support and management for coded conditions. Identify ...

... for risk adjustment coding. The coder will identify risk adjustment codes based upon coding ... The coder will meet 3x a week with a coding manager to review metrics and progress to-date.

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ... You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open ...

Risk Adjustment Coder II

Houston, TX · On-site

$27.69 - $34.61/hr

... coding guidelines for Commercial and Medicare risk adjustment programs.Conduct thorough clinical documentation review to ensure sufficient support and management for coded conditions.Identify ...

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82K - $108K/yr

Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ... You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open ...

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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 Jul 23, 2026, the average hourly pay for risk adjustment coding manager in the United States is $33.02, according to ZipRecruiter salary data. Most workers in this role earn between $25.00 and $39.90 per hour, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive as a Risk Adjustment Coding Manager, and why are they important?

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 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 Risk Adjustment Coding Managers?

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.
More about Risk Adjustment Coding Manager jobs
What cities are hiring for Risk Adjustment Coding Manager jobs? Cities with the most Risk Adjustment Coding Manager job openings:
What are the most commonly searched types of Risk Adjustment Coding jobs? The most popular types of Risk Adjustment Coding jobs are:
What states have the most Risk Adjustment Coding Manager jobs? States with the most job openings for Risk Adjustment Coding Manager jobs include:
Infographic showing various Risk Adjustment Coding Manager job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 77% Full Time, 14% Part Time, and 8% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution, with an average salary of $68,683 per year, or $33 per hour.
HEALTH CODER - HCC & RISK ADJUSTMENT

HEALTH CODER - HCC & RISK ADJUSTMENT

NORTH EAST MEDICAL SERVICES

Burlingame, CA • Remote

$42.79 - $48.75/hr

Other

Posted 7 days ago


Job description

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization’s quality outcomes and financial performance.

ESSENTIAL JOB FUNCTIONS:

  • HCC Coding and Risk Adjustment (RA) Program Support
    • Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
    • Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
    • Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
  • Provider Training and Clinical Documentation Improvement (CDI)
  • Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
  • Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
  • Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
  • Data Analysis and Reporting
    • Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
    • Generate reports and dashboards to track coding performance and documentation accuracy.
    • Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
  • Compliance and Continuous Improvement
    • Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
    • Assist in the development and implementation of internal coding policies and procedures.
    • Participate in quality improvement initiatives related to coding and documentation.
    • Performs other job duties as required by manager/supervisor
  • Education & Certification:
    • BS/BA Degree in Health Science or General Education is required. 
    • Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
    • Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
  • Experience:
    • Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
    • Experience in provider education, clinical documentation improvement (CDI), and chart audits.
    • Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
  • Skills & Competencies:
    • Excellent communication, presentation, and interpersonal skills.
    • Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
    • Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
    • Proficiency in electronic health records (EHR) and coding software.
    • Strong analytical and problem-solving skills.

LANGUAGE:

  • Must be able to fluently speak, read and write English.
  • Fluency in other languages is an asset.

STATUS:

  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This a full-time position.