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Risk Adjustment Coding Jobs in California (NOW HIRING)

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Risk Adjustment Coding information

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$69

How much do risk adjustment coding jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for risk adjustment coding in California is $28.90, according to ZipRecruiter salary data. Most workers in this role earn between $21.59 and $28.70 per hour, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive as a risk adjustment coder?

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.

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 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, certifications, and location. Entry-level positions may start around $45,000, while experienced coders with certifications like CPC or CCS can earn over $80,000. The role often requires knowledge of medical coding systems and familiarity with healthcare data analysis.

How to get into risk adjustment coding?

To enter risk adjustment coding, individuals typically need a medical coding certification such as CPC or CCS, along with knowledge of medical records and coding guidelines. Experience in healthcare or medical billing can be beneficial, and familiarity with electronic health records (EHR) systems is often required. Ongoing education and staying current with coding updates are important for success in this field.

What do risk adjustment coders do?

Risk adjustment coders review and assign medical codes to patient records to accurately reflect diagnoses and health conditions, which are used to calculate risk scores for insurance reimbursement and quality measurement. They ensure coding accuracy and compliance with industry standards, often using coding tools and guidelines such as ICD-10 and CPT. Attention to detail and knowledge of medical documentation are essential for this role.

What are the most commonly searched types of Risk Adjustment Coding jobs in California?

The most popular types of Risk Adjustment Coding jobs in California are:

What are popular job titles related to Risk Adjustment Coding jobs in California?

For Risk Adjustment Coding jobs in California, the most frequently searched job titles are:

What job categories do people searching Risk Adjustment Coding jobs in California look for?

The top searched job categories for Risk Adjustment Coding jobs in California are:

What cities in California are hiring for Risk Adjustment Coding jobs?

Cities in California with the most Risk Adjustment Coding job openings:

Risk Adjustment Coding jobs near you
Infographic showing various Risk Adjustment Coding job openings in California as of August 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $60,122 per year, or $28.9 per hour.

Risk Adjustment Coding Specialist

Greater Good Health

El Segundo, CA • On-site

Other

Medical, Dental, Vision, Retirement, PTO

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

Job Title: Risk Adjustment Coding Specialist
Job Location: El Segundo HQ
Company Description
Greater Good Health is a fast-growing organization delivering care to older adults in access starved communities. Our innovative model is led by Nurse Practitioners and focused on outcomes, not volume-meaning we prioritize quality over quantity, spend more time with our patients, and are accountable for their health and well-being.
Whether through our own senior-focused primary care clinics or our suite of integrated clinical solutions for health plans and provider groups, we are making value-based care more accessible and more effective. We help reduce avoidable healthcare costs, improve clinical outcomes, and create a best-in-class patient experience.
If you're passionate about transforming healthcare and delivering meaningful care to those who need it most, Greater Good Health offers a purpose-driven, collaborative, and supportive environment where your work can make a lasting impact.
The Role
We are looking for a Risk Adjustment Coding Specialist to own retrospective CDI chart review and strengthen coding compliance, documentation accuracy, and risk adjustment optimization across our Medicare-focused primary care model. The ideal candidate brings deep expertise in Medicare risk adjustment, a strong understanding of outpatient clinical documentation, and the ability to translate complex coding requirements into practical guidance for clinical and revenue teams.
This role will work closely with leaders across Revenue Cycle, Clinical Operations & Clinical Performance to drive compliant, accurate, and optimized coding - resolving documentation and coding queries, closing retrospective review backlogs against CMS filing deadlines, and identifying opportunities to improve risk capture while reducing audit risk. The ability to communicate clearly with both clinical and non-clinical stakeholders is essential.
This role will ensure coding accuracy and consistency by helping design and formalize coding audit processes, documentation standards, and education materials. You will review charts, support query resolution, and provide insights into coding trends and regulatory changes that impact our operations.
The right person for this role will apply their extensive knowledge of Medicare risk adjustment coding to real-world clinical workflows, balancing compliance, operational efficiency, and scalability. This role offers meaningful autonomy, a focused but impactful scope, and the opportunity to directly strengthen our coding and compliance foundation as we continue to grow.
Responsibilities
  • Own retrospective CDI chart review for compliant, accurate and optimized coding
  • Design and execute formal coding audits to ensure CPT and diagnosis coding are compliant and fully supported by clinical documentation
  • Identify documentation gaps, education opportunities, and compliance concerns; support escalation and remediation efforts as needed
  • Partner with Revenue Cycle to support claim corrections, rebilling, and documentation follow-up
  • Assist with coding research for new or evolving CPTs and services, including documentation and billing requirements and Medicare reimbursement considerations
  • Support resolution of coding and documentation queries, collaborating with providers to amend documentation where appropriate
  • Develop coding and documentation education content for Nurse Practitioners and clinical teams, informed by audit findings and recurring themes
  • Build and maintain CDI worklists and audit trackers in Excel, including formula-driven flags for missed HCCs, recapture opportunities, and documentation gaps
  • Translate chart audit findings into structured Excel-based reporting (trend summaries, provider-level scorecards) for Revenue Cycle and Clinical Operations leadership
  • Support Care Services leadership with open condition management and risk adjustment workflows, including coaching and training as needed
  • Monitor and report on changes in the coding and risk adjustment landscape, including new, revised, or retired codes and regulatory guidance
  • Help formalize coding-related processes and documentation suitable for internal policies and compliance reference
Qualifications
Credentials & Certifications
  • Certified Risk Adjustment Coder (CRC or equivalent) required
  • CDI credential preferred (CDIP, CCDS, or equivalent) in addition to CRC
Clinical & Coding Experience
  • Medicare risk adjustment experience required
  • Demonstrated Clinical Documentation Improvement (CDI) experience, including query construction, provider education, and documentation gap remediation
  • Strong knowledge of ICD-10-CM coding guidelines, HCC models, and Medicare documentation requirements
  • Experience in outpatient clinic and/or primary care settings
  • Value-Based Care (VBC) experience
  • Experience supporting or participating in coding audits or compliance reviews preferred
Technical Skills
  • Proficiency in Excel, including pivot tables, VLOOKUP/XLOOKUP, conditional formatting, and data validation, for chart audit tracking and trend reporting
  • Experience building or maintaining audit worklists/trackers in Excel
Communication & Collaboration
  • Strong communication skills with the ability to translate coding guidance for clinical, operational, and finance stakeholders
  • Comfortable training and coaching providers on documentation and coding best practices, including delivering feedback on individual query patterns
What Will Make You Successful at GGH
  • If you "bring it" every day and are continually hungry to learn, share, and tackle challenges.
  • You thrive in an environment that champions learning, growth, agency, and autonomy. We support each team member to work at the "top of their license" and find fulfillment in their work.
  • We can trust that your words and actions align. We own our mistakes and share our learning with others. We think and act with consideration for people, time, rules, resources, ethics, and GGH's success.
Perks and Benefits:
Lunch and parking provided every day in office!
  • Competitive Compensation Package: We offer a competitive compensation package to recognize your valuable contributions and ensure your financial security.
  • Comprehensive Medical, Dental, and Vision Benefits: Take advantage of comprehensive healthcare coverage, including medical, dental, and vision benefits, to prioritize your health and well-being.Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) available.
  • Paid Time Off: Enjoy paid holidays, vacation time, and paid parental leave to maintain a healthy work-life balance and spend quality time with your loved ones.
  • 401K Program with Company Match: Plan for your future with our 401K program, featuring a company match, to help you save for retirement.
  • Monthly Phone/Internet Reimbursement: Stay connected with our monthly phone and internet reimbursement, ensuring you have the tools you need to excel in your role.
  • Comprehensive Life and AD&D Coverage: Enjoy peace of mind with 100% premiums covered by GGH for Basic Life and Accidental Death & Dismemberment (AD&D) insurance for full-time team members. Additionally, voluntary supplemental life insurance is offered at a discounted rate.
  • Short-Term Disability Coverage: Gain additional financial security with voluntary short-term disability (STD) coverage. This benefit provides a percentage of your salary during periods of illness or injury that prevent you from working for a set period of time.
  • Collaborative and Supportive Community: Join our collaborative and supportive GGH Nurse Practitioner Community, with dedicated care coordinators and MD advisors, to foster professional growth and success

Don't check off every box in the requirements listed above? Please apply anyway! Studies have shown that marginalized communities - such as women, LGBTQ+ and people of color - are less likely to apply to jobs unless they meet every single qualification. GGH is dedicated to building an inclusive, diverse, equitable, and accessible workplace that fosters a sense of belonging - so if you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, we encourage you to still consider applying. You may be just the right candidate for this role or another one of our openings!
Pay Range: $80,000 - $95,000 per year

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