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Risk Adjustment Coding Jobs in Colorado (NOW HIRING)

Phpmcs

Physician - Primary Care

Denver, CO · On-site

$200 - $250/hr

PHPprime provides wrap-around services to help make our practice successful, including care coordination, practice transformation coaching, risk adjustment coding education, population health ...

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Phpmcs

Physician, MD - Aurora

Aurora, CO · On-site

$200 - $250/hr

PHPprime provides wrap-around services to help make our practice successful, including care coordination, practice transformation coaching, risk adjustment coding education, population health ...

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All JobsRisk Adjustment Coding JobsRisk Adjustment Coding Jobs in Colorado

Risk Adjustment Coding information

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How much do risk adjustment coding jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for risk adjustment coding in Colorado is $30.80, according to ZipRecruiter salary data. Most workers in this role earn between $22.98 and $30.58 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 Colorado?

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

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

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

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

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

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

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

Risk Adjustment Coding jobs near you
Infographic showing various Risk Adjustment Coding job openings in Colorado as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $64,058 per year, or $30.8 per hour.

Program Manager, Risk Adjustment & Stars

Alpine Physician Partners

Denver, CO

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 8 days ago

Job description

Are you looking to work for a company that has been recognized for over a decade as a Top Place to Work? Apply today to become a part of a company that continues to commit to putting our employees first.
Job Description:
OVERVIEW OF POSITION:
The Program Manager, Risk Adjustment & Stars, serves as the connective link between Alpine's technical teams (coding, data, analytics, IT) and its operational and business stakeholders (leadership, quality, health plan operations) for risk adjustment and Star Ratings performance. This role translates technical details, such as data pipelines, coding logic, and CMS methodology, into operational plans, priorities, and decisions, while ensuring operational requirements and business goals are reflected back into the technical work. The role does not require direct provider-facing engagement.
ESSENTIAL DUTIES:
Program Management
  • Owns the annual risk adjustment and Stars improvement program cycle, coordinating between technical teams and operational/business stakeholders across prospective and retrospective programs, visit-based campaigns, and gap closure workflows.
  • Builds and manages program timelines and throughput; reports progress to Alpine leadership and health plan partners in clear, business-friendly terms.
  • Leads cross-functional workgroups spanning coding/HCC teams, clinical quality, IT, and analytics, ensuring technical work stays aligned to operational priorities.
  • Manages program-level documentation and requirements, translating between technical specifications and operational plans.
Risk Adjustment
  • Acts as the liaison between coding/data teams and operational stakeholders on HCC capture workflows, chart review pipelines, and gap identification, ensuring both sides understand priorities and constraints.
  • Manages relationships with vendors, coordinating technical file exchange and integration needs with operational timelines and expectations.
  • Monitors RAF score trends and performance results, working with analytics teams to interpret findings and translates them into operational action plans.
  • Coordinates risk adjustment data submission accuracy and reconciliation (EDS), connecting technical issue resolution with business and health plan deadlines.
  • Tracks HCC model version transitions (e.g., CMS-HCC V24/V28) and communicates their operational and financial impact to leadership and business teams.
Stars & Quality
  • Coordinates Alpine's Star Ratings strategy across HEDIS, CAHPS, HOS, and medication adherence measures, connecting technical measure logic with operational execution.
  • Partners with analytics teams to maintain measure-level performance tracking and cut-point modeling, translating results into operational priorities and gap closure plans.
  • Serves as one point of contact for Alpine with health plan Stars/quality teams, bridging technical data exchange requirements with operational and contractual needs.
Analytics & Reporting
  • Partners with analytics and data teams to define KPIs and dashboards for RAF accuracy, coding gap closure rates, and Star measure performance, ensuring outputs are operationally useful.
  • Translates CMS methodology updates (HCC model version changes, Star Ratings technical notes, measure weighting changes) for both technical teams (as specifications) and operational teams (as business impact).
  • Helps identify and escalate data integrity issues across source systems (claims, EHR, supplemental data feeds), coordinating resolution between technical and operational owners.
  • Presents performance results and program recommendations to Alpine executive leadership and payer partners.
Compliance & Governance
  • Ensures all program activities comply with CMS regulations, ICD-10-CM coding guidelines, and Alpine's compliance policies.
  • Supports RADV audit readiness and health plan data validation requests, coordinating between technical teams pulling data and operational/compliance teams managing the response.

EDUCATION:
Bachelor's degree in health informatics, data analytics, healthcare administration, business, or related field (Master's preferred).
EXPERIENCE:
Five (5) to seven (7) years of experience in Medicare Advantage risk adjustment and/or Star Ratings/quality improvement, ideally within a value-based care (VBC) setting.
Preferred Qualifications
• Certified Risk Adjustment Coder (CRC) credential.
• Experience with value-based care, ACOs, or delegated risk arrangements.
• Familiarity with multiple health plan Stars/quality programs and data exchange requirements.
• PMP or similar certification.
KNOWLEDGE, SKILLS, ABILITIES:
  • Working knowledge of CMS HCC risk adjustment models, RAF score methodology, EDS submission processes, and Star Ratings measure specifications.
  • Demonstrated ability to work effectively with both technical teams (data, analytics, IT) and operational/business stakeholders, translating between the two.
  • Proven program/project management experience managing cross-functional initiatives involving both technical and operational workstreams.
  • Working proficiency in Excel required; familiarity with SQL, Tableau, Power BI, or similar tools a plus.
  • Strong written and verbal communication skills, with the ability to translate technical and regulatory detail for operational and executive audiences.
  • Skilled at translating between technical and operational audiences, comfortable in both worlds without needing to be a deep technical expert.
  • Strong relationship management and cross-functional collaboration skills.
  • Analytical and detail-oriented, able to interpret data and technical findings and turn them into operational plans.
  • Adaptable to evolving CMS methodology and health plan requirements.
    • Able to travel to meetings
    • Ability to handle multiple demands concurrently in a high stress environment; organize, coordinate, set priorities and meet deadlines
    • Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures

Salary Range:
Salary Range: $83,990.40-$119,974.40
Additional Compensation: Eligible for annual bonus based on individual and/or company performance.
Benefits: Includes medical, dental, and vision insurance; 401(k); paid time off (PTO); and Employee Assistance Program (EAP)
Application Deadline: Open until filled. Applications will be reviewed on a rolling basis.
How to Apply: Apply via careers page at https://alpinephysicians.wd1.myworkdayjobs.com/external

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