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Risk Adjustment Coding Jobs (NOW HIRING)

Mercor

HCC Coding Leader - Risk Adjustment

New York, NY · Remote

$110/hr

Risk-adjustment / HCC coding leader Type: Contract Compensation: $110/hour Location: Remote Role Responsibilities * Lead risk adjustment and HCC coding operations across Medicare Advantage , Medicaid ...

Stanford Health Care

Sr Risk Adjustment Coder

Newark, NJ

$44.13 - $57.36/hr

The HCC Coding Auditor Senior will be involved with activities of quality assurance auditing and risk adjustment code abstraction for the following programs: including but not limited to Medicare ...

Community Health Choice

Risk Adjustment Coder II

Houston, TX · On-site

$18 - $23.75/hr

Stay current with coding standards, risk adjustment methodologies, and CMS Regulatory changes to ensure ongoing compliance and optimal coding practices. 5% Actively contributes to achievement of ...

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Risk Adjustment Coding information

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How much do risk adjustment coding jobs pay per hour?

As of Jul 10, 2026, the average hourly pay for risk adjustment coding in the United States is $29.29, according to ZipRecruiter salary data. Most workers in this role earn between $21.88 and $29.09 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.
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Risk Adjustment Coding jobs near you
Infographic showing various Risk Adjustment Coding job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 14% Part Time, and 7% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $60,920 per year, or $29.3 per hour.

Risk Adjustment Coding Specialist II - Houston

Astrana Health, Inc.

Houston, TX • Hybrid

$70K - $85K/yr

Full-time

Posted 16 days ago

Job description

Description
We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Houston market.  In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You’ll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you’ll track and report on key performance metrics—such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success. 
We are seeking candidates who have experience with provider education and at least 3-5 years of risk adjustment experience! This position requires travel to provider offices up to 75% of the time in the Houston area.
Our Values: 
  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence
  • Be Innovative
  • Work As One Team

What You'll Do
  • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company
  • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC) 
  • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines 
  • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing
  • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
  • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives.
  • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work.
  • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager.
  • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I
  • Other duties as assigned

Qualifications
  • Required Certification/Licensure: Must possess and maintain AAPC certification, CPC and CRC.
  • At least 3 years of experience in risk adjustment coding and/or billing experience required.
  • At least 1 year of experience with targeted provider education.
  • Reliable transportation/Valid Driver’s License/Must be able to travel up to 75% of work time
  • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
  • Excellent presentation, verbal and written communication skills, and ability to collaborate 
  • Must possess the ability to educate and train provider office staff members
  • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.
You're great for this role if:    
  • Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
  • Strong PowerPoint and public speaking experience
  • Ability to work independently and collaborate in a team setting
  • Experience with Monday.com
  • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting


Environmental Job Requirements and Working Conditions
  • The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
  • This role follows a hybrid work structure where the expectation is to work in the office, in the field and at home on a weekly basis. 19500 HWY 249, Suite 570 Houston, TX 77070. This position requires up to 75% travel to provider offices in Houston.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.    

Additional Information:     
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.