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Risk Adjustment Coding Jobs in Baltimore, MD (NOW HIRING)

CenterWell

Risk Adjustment Coding Analyst

Annapolis, MD · On-site

Become a part of our caring community The Risk Adjustment Coding Analyst provides operational, analytical, and administrative support to business leaders and teams. You will analyze data to support ...

RELI Group Inc.

Medical Coder

Baltimore, MD · On-site +1

$45K - $55K/yr

Perform diagnosis coding of inpatient, outpatient, and physician office medical records per Risk Adjustment/Medicare Part C guidelines. * Perform intake validity checks on each medical record ...

RELI GROUP INC

Medical Coder

Baltimore, MD · On-site

$45K - $55K/yr

Perform diagnosis coding of inpatient, outpatient, and physician office medical records per Risk Adjustment/Medicare Part C guidelines. * Perform intake validity checks on each medical record ...

RELI Group

Medical Coder

Baltimore, MD · On-site +1

$45K - $55K/yr

Perform diagnosis coding of inpatient, outpatient, and physician office medical records per Risk Adjustment/Medicare Part C guidelines. * Perform intake validity checks on each medical record ...

RELI GROUP INC

Medical Coder

Baltimore, MD

$45K - $55K/yr

Perform diagnosis coding of inpatient, outpatient, and physician office medical records per Risk Adjustment/Medicare Part C guidelines. * Perform intake validity checks on each medical record ...

RELI GROUP INC

Medical Coder

Baltimore, MD · On-site

$45K - $55K/yr

Perform diagnosis coding of inpatient, outpatient, and physician office medical records per Risk Adjustment/Medicare Part C guidelines. * Perform intake validity checks on each medical record ...

RELI GROUP INC

Senior Medical Coder

Baltimore, MD · On-site

$65K/yr

Perform diagnosis coding of inpatient, outpatient, and physician office medical records per Risk Adjustment/Medicare Part C guidelines. * Perform intake validity checks on each medical record ...

HealthCare Resolution Services

Medical Coder

Columbia, MD · Remote

$19.25 - $25.50/hr

As an HCC Coding Analyst, you will play a vital role in ensuring accurate documentation and coding ... Understanding of the CMS guidelines for risk adjustment models and reimbursement policies.Excellent ...

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Risk Adjustment Coding information

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How much do risk adjustment coding jobs pay per hour?

As of Aug 26, 2026, the average hourly pay for risk adjustment coding in Baltimore, MD is $29.10, according to ZipRecruiter salary data. Most workers in this role earn between $21.73 and $28.89 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 popular job titles related to Risk Adjustment Coding jobs in Baltimore, MD?

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

What job categories do people searching Risk Adjustment Coding jobs in Baltimore, MD look for?

The top searched job categories for Risk Adjustment Coding jobs in Baltimore, MD are:

What cities near Baltimore, MD are hiring for Risk Adjustment Coding jobs?

Cities near Baltimore, MD with the most Risk Adjustment Coding job openings:

Risk Adjustment Coding jobs near you
Infographic showing various Risk Adjustment Coding job openings in Baltimore, MD as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 11% Part Time, and 2% Contract. Highlights an 85% Physical, 5% Hybrid, and 10% Remote job distribution, with an average salary of $60,529 per year, or $29.1 per hour.

Risk Adjustment Coding Specialist (Hybrid)

Baltimore, MD • On-site

CareFirst BlueCross BlueShield

7.3

Company rating: 7.3 out of 10

Based on 31 frontline employees who took The Breakroom Quiz

240th of 312 rated insurance

People enjoy working here

Good employer

Recommended by parents

Learn more about CareFirst BlueCross BlueShieldexternal

$51K - $95K/yr

Other

Retirement

Re-posted 21 days ago

Job description

Resp & Qualifications

PURPOSE:

The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, HHS-Risk Adjustment Data Validation (RADV) audit and any other chart coding functions, by performing moderately complex medical record review and coding, ensuring compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines. The development and ongoing maintenance of the Commercial Risk Adjustment Coding guidelines, as well as, guiding junior coding specialists are included in the job responsibilities. We are looking for an experienced professional in the greater Baltimore metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week.

ESSENTIAL FUNCTIONS:

  • Verifies accuracy, completeness, and appropriateness of diagnosis codes based on medical documentation provided at all levels of complexity. Utilizes appropriate coding guidelines and recommends any changes to diagnosis codes based on chart review. Achieves and maintains coding accuracy levels greater than 90%. Works with vendors, providers and hospital staff to coordinate record access.

  • Identifies and documents coding observations or discrepancies and provides information to management team to further enhance quality and/or provider education. Work with leadership and third-party vendors to negotiate agreement on complex medical record diagnoses and determine compliance with coding guidelines which will be accepted by the federal government. Develops and conducts new physician/other healthcare practitioner coding orientation/education, including group or individual sessions. Develop and maintain coding guidelines for Commercial Risk Adjustment, maintaining those guidelines for any changes in industry standards.

  • Provide guidance and direction to Coding Specialists when reviewing complex medical records to help guide in determining appropriate coding.

SUPERVISORY RESPONSIBILITY:

Position does not have direct reports but is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources.

QUALIFICATIONS:

Education Level: Associate degree in Health Information Technology, Business or related field OR in lieu of a Associate degree, an additional 2 years of relevant work experience is required in addition to the required work experience.

Experience: 3 years risk adjustment/hierarchical condition category (HCC) coding experience.

Licenses/Certifications :

  • CCS-Certified Coding Specialist or CPC, CCS-P, CRC Upon Hire Required

  • RHIT - Registered Health Information Technician or RHIA Upon Hire Preferred

Knowledge, Skills and Abilities (KSAs)

  • Adobe Acrobat Professional.

  • Microsoft Word, Excel, Outlook, Claims Processing, Facets.

  • Ability to adapt to various coding technology platforms, such as Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems and coding documentation platforms.

  • Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Travel Requirements :

Estimate Amount: 5% medical sites to supervise medical record retrieval, conferences

Salary Range: $51,984 - $95,304

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

Physical Demands:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship.

#LI-NH2

REQNUMBER: 22242

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