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Risk Adjustment Coding Jobs in Virginia (NOW HIRING)

Sentara Health

Risk Adjustment Coder

Virginia Beach, VA · Hybrid

$10K/mo

Reviews provider coding for professional & inpatient/outpatient services to ensure capture of ... Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits ...

Humana

Medical Coding Educator

Richmond, VA · On-site

$27 - $30.75/hr

Will report to the Manager, Medicare Risk Adjustment. As the Medical Coding Educator 2 you will * Arrange educational sessions with assigned providers aimed at quality of care and documentation ...

New

Albanymed

Senior Professional Coder

Broadway, VA · Remote

$64K - $97K/yr

Act as an expert for the HCC/Risk adjustment coding. This position is remote but does require onsite education to providers as needed. Essential Duties and Responsibilities * Review, analyze, and ...

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Risk Adjustment Coding information

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$16

$29

$70

How much do risk adjustment coding jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for risk adjustment coding in Virginia is $29.04, according to ZipRecruiter salary data. Most workers in this role earn between $21.68 and $28.85 per hour, depending on experience, location, and employer.

How long does it take to become a risk adjustment coder?

Becoming a risk adjustment coder typically requires completing a specialized training program or certification, which can take from a few months up to a year. Many professionals also pursue coding certifications such as CPC or CCS to enhance their skills and job prospects, with some gaining experience through on-the-job training during this period.

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.

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.

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.

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 are the most commonly searched types of Risk Adjustment Coding jobs in Virginia? The most popular types of Risk Adjustment Coding jobs in Virginia are:
What are popular job titles related to Risk Adjustment Coding jobs in Virginia? For Risk Adjustment Coding jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Risk Adjustment Coding jobs in Virginia look for? The top searched job categories for Risk Adjustment Coding jobs in Virginia are:
What cities in Virginia are hiring for Risk Adjustment Coding jobs? Cities in Virginia with the most Risk Adjustment Coding job openings:
Risk Adjustment Coding jobs near you
Infographic showing various Risk Adjustment Coding job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, and 4% Contract. Highlights an 88% Physical, 4% Hybrid, and 8% Remote job distribution, with an average salary of $60,397 per year, or $29 per hour.

Risk Adjustment Coder

Sentara Health

Virginia Beach, VA • Hybrid

$10K/mo

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 398 frontline employees who took The Breakroom Quiz

491st of 887 rated healthcare providers

Job description

City/State
Virginia Beach, VA
Work Shift
First (Days)
Overview:
Sentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA!
Hours:Monday - Friday, 8:00AM -5:00PM, dayshift.
This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week. The role also includes travel as needed to support business objectives and team collaboration.
Overview
Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments, training, monitoring, & auditing, control assessment, reporting, investigation, root cause analysis, and corrective action oversight. Performs vendor quality oversight audits; reviews and/or makes final coding determination for non-agreeable coding. Makes final decision on vendor-to-vendor diagnosis coding rebuttal concerns. Serves as subject matter expert on risk adjustment diagnosis coding guidelines. Coordinates risk adjustment gap elimination with clinical and quality gap elimination Maintains a reasonable fluency in workings & financial implications of applicable risk adjustment models.
Education
  • Associate degree ( Required )

Experience
  • Medical Records Data - 1 year ( Required )
  • Coding - 2 years ( Required )

Certifications:
One of the following certifications are required: Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist-Physician-based (CCS-P), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA).
Must obtain Certified Risk Adjustment Coder (CRC) certification within two years of employment.
Keywords: Risk Adjustment Coding & Documentation Specialist, Talroo-Allied Health, Medical Office
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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