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Risk Adjustment Coding Jobs in Springfield, MA (NOW HIRING)

Corvel

Bill Review Analyst I

East Hartford, CT · Hybrid

$16.94 - $23.42/hr

Knowledge of CPT/ICD/HCPS coding * Knowledge of UBO4/DWC-9/DWC-10 and CMS 1500 form types preferred ... The level may impact the salary range and these adjustments would be clarified during the offer ...

Corvel

Bill Review Analyst I

East Hartford, CT · On-site

$16.94 - $23.42/hr

Knowledge of CPT/ICD/HCPS coding * Knowledge of UBO4/DWC-9/DWC-10 and CMS 1500 form types preferred ... The level may impact the salary range and these adjustments would be clarified during the offer ...

Cadrex Agawam

CNC Machinist III - 1st Shift

Agawam, MA · On-site

$36 - $45/hr

Knowledge of G-code and CAM software is essential * Operate CNC machines to produce components ... The employee is occasionally exposed to the risk of electrical shock. The noise level in the work ...

Care-One

Unit Manager/RN Supervisor

Northampton, MA · On-site

$104K - $114K/yr

Make sure that staffing level adjustments are made each shift as needed and the Federal required ... Attend, participate and lead the weekly resident "At Risk" meeting ensures resident care and ...

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All JobsRisk Adjustment Coding JobsRisk Adjustment Coding Jobs in Springfield, MA

Risk Adjustment Coding information

See Springfield, MA salary details

$17

$29

$70

How much do risk adjustment coding jobs pay per hour?

As of Jul 28, 2026, the average hourly pay for risk adjustment coding in Springfield, MA is $29.19, according to ZipRecruiter salary data. Most workers in this role earn between $21.78 and $28.99 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 are popular job titles related to Risk Adjustment Coding jobs in Springfield, MA? For Risk Adjustment Coding jobs in Springfield, MA, the most frequently searched job titles are:
What job categories do people searching Risk Adjustment Coding jobs in Springfield, MA look for? The top searched job categories for Risk Adjustment Coding jobs in Springfield, MA are:
Risk Adjustment Coding jobs near you
Infographic showing various Risk Adjustment Coding job openings in Springfield, MA as of July 2026, with employment types broken down into 1% As Needed, 76% Full Time, 16% Part Time, 1% Temporary, and 6% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution, with an average salary of $60,706 per year, or $29.2 per hour.
Senior Manager, Corporate Compliance - Risk Adjustment

Senior Manager, Corporate Compliance - Risk Adjustment

CVS Health

Hartford, CT

$75K - $165K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 5 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,319 frontline employees who took The Breakroom Quiz

88th of 109 rated pharmacies

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements. This position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements.

The ideal candidate possesses extensive experience in Medicare Advantage compliance and a deep understanding of CMS Risk Adjustment methodologies, diagnosis coding requirements, medical record documentation standards, RADV audits, and evolving regulatory guidance.

Key Responsibilities

  • Lead the Medicare Advantage Risk Adjustment compliance program.

  • Monitor and interpret CMS regulations, HPMS memoranda, Final Rules, Medicare Managed Care Manual guidance, RADV requirements, and OIG enforcement activities.

  • Assess operational processes for compliance risks related to risk adjustment activities.

  • Develop and implement corrective action plans for identified compliance issues.

  • Conduct compliance risk assessments related to coding, documentation, and encounter data submissions.


Required Qualifications

  • Minimum 7 years of experience in Medicare Advantage, Risk Adjustment, Coding Compliance, Audit, or Regulatory Compliance

  • Minimum 5 years in a leadership role

  • One or more of the following certifications: CPMA (Certified Professional Medical Auditor), CRC (Certified Risk Adjustment Coder), CPC (Certified Professional Coder), CCS (Certified Coding Specialist)

  • Willingness to travel up to 10% (including by plane)


Preferred Qualifications

  • Health Information Management (RHIA/RHIT)

  • Nursing - Strong understanding of clinical documentation and medical record review

  • Certified Risk Adjustment Coder (CRC) with compliance experience

  • Provider coding audit/compliance leadership experience

  • Medicare Advantage compliance leadership experience supporting RADV, HCC validation, and CMS audits


Education

Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, Public Health, Business Administration, Healthcare Compliance, or a related healthcare field required; equivalent years of work experience may substitue.

Pay Range

The typical pay range for this role is:

$75,400.00 - $165,954.00


This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/12/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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