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Risk Adjustment Coding Jobs in Arizona (NOW HIRING)

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

The Associate, Risk Adjustment Auditor conducts internal and external quality audits ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

Phoenix , AZ Please find the JD Below The Risk Adjustment Analyst serves as a data and strategic specialist who tracks health plan performance and financial risk By using advanced coding ...

CDI Specialist RN Ld

Phoenix, AZ · On-site

$39.96 - $58.94/hr

Advanced knowledge of ICD-10-CM/PCS, MS-DRG/APR-DRG methodologies, risk adjustment, and coding compliance. * Strong clinical validation expertise and critical-thinking skills. * Ability to deliver ...

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Risk Adjustment Coding information

See Arizona salary details

$15

$27

$66

How much do risk adjustment coding jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for risk adjustment coding in Arizona is $27.29, according to ZipRecruiter salary data. Most workers in this role earn between $20.38 and $27.12 per hour, depending on experience, location, and employer.

Is HCC coding a good career?

Risk adjustment coding, including HCC coding, is a growing field with strong job demand due to the increasing focus on value-based care and accurate risk assessment. It requires attention to detail, knowledge of medical terminology, and often certification, making it a stable career option for those interested in healthcare and coding. Opportunities exist in healthcare organizations, insurance companies, and consulting firms.

What is a risk adjustment coder?

A risk adjustment coder is a healthcare professional responsible for reviewing medical records and assigning accurate diagnosis codes to reflect patient health status. Their work supports insurance reimbursement and quality measurement by ensuring proper risk adjustment, often requiring knowledge of coding systems like ICD-10 and certification such as CPC.

What is risk adjustment coding?

Risk adjustment coding is the process of assigning standardized diagnosis codes to patient records to accurately reflect their health status and predict future healthcare costs. These codes are used by health plans and government programs to adjust payments based on the complexity and severity of patient conditions. Proper risk adjustment coding ensures fair reimbursement and supports quality care management by identifying high-risk patients who may require additional resources.

What is the difference between Risk Adjustment Coding vs Medical Coding?

AspectRisk Adjustment CodingMedical Coding
CredentialsCPR, CPC, or CCS certifications often preferredCPR, CPC, or CCS certifications
Work EnvironmentHealthcare facilities, insurance companies, remoteHospitals, clinics, physician offices
Industry UsageHealth plans, risk adjustment programsGeneral healthcare billing and documentation

Risk Adjustment Coding focuses on assigning codes that predict healthcare costs and risk for insurance purposes, often requiring understanding of patient risk factors. Medical Coding covers a broader range of diagnoses and procedures for billing and documentation. While both roles require similar certifications, their work environments and industry applications differ significantly.

How much does a CRC coder make?

A Certified Risk Adjustment Coder (CRC) typically earns between $50,000 and $70,000 annually, depending on experience, location, and employer. Certification and proficiency with coding tools like ICD-10 are important factors that can influence salary levels.

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, healthcare regulations, and anatomy, typically supported by certification such as CPC or CRC. Familiarity with coding software, EHR systems, and risk adjustment models like HCC or CMS-HCC is crucial. Attention to detail, analytical thinking, and effective communication are standout soft skills for this role. These skills ensure accurate coding, compliance, and optimized reimbursement, which are vital for healthcare organizations' financial and regulatory success.

What are some common challenges faced by professionals in risk adjustment coding, and how can they be managed?

Risk adjustment coders often encounter challenges such as keeping up with frequent updates to coding guidelines, ensuring complete and accurate documentation, and managing high volumes of medical records. To address these challenges, effective time management, continuous education on coding standards (like ICD-10-CM), and regular communication with healthcare providers are essential. Many coders also rely on auditing tools and ongoing feedback from team leads to improve accuracy and compliance, fostering a collaborative and supportive work environment.

How to get into risk adjustment coding?

To enter risk adjustment coding, individuals typically need a background in medical coding, health information management, or related healthcare fields, along with certification such as the Certified Professional Coder (CPC) or Certified Coding Specialist (CCS). Gaining experience with medical records, coding software, and understanding diagnosis and procedure coding guidelines is essential. Many employers also value familiarity with risk adjustment models and coding for chronic conditions.
What cities in Arizona are hiring for Risk Adjustment Coding jobs? Cities in Arizona with the most Risk Adjustment Coding job openings:
Infographic showing various Risk Adjustment Coding job openings in Arizona as of July 2026, with employment types broken down into 84% Full Time, 5% Part Time, and 11% Contract. Highlights an 84% In-person, 5% Hybrid, and 11% Remote job distribution, with an average salary of $56,770 per year, or $27.3 per hour.
Auditor, Risk Adjustment

Auditor, Risk Adjustment

Oscar Health

Tempe, AZ • Remote

$82K - $108K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 27 days ago


Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

247th of 298 rated insurance


Job description

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Associate, Risk Adjustment Auditor conducts internal and external quality audits. Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and identified clinical documentation improvement opportunities. You will work with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs.

You will report into the Manager, Risk Adjustment.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

  • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts.
  • Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation
  • Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented.
  • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards.
  • Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits.
  • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process.
  • Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business.
  • Manage the implementation process improvements that will maximize risk adjustment factor increases.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Bachelor's degree in a relevant field of study or commensurate work experience.
  • Certified professional coder (CPC)
  • 3+ year(s) retrospective risk adjustment coding experience.
  • 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV) experience

Bonus points:

  • Certified Risk Adjustment Coder (CRC) or similar certification
  • Experience coding in a variety of different Electronic Medical Record (EMR) systems.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.


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