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Risk Adjustment Coding Jobs (NOW HIRING)

Astrana Health Management

$70 - $85/hr

Risk Adjustment Coding Specialist II (CST/EST) Department: Quality - Risk Adjustment Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Liz ...

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How much do risk adjustment coding jobs pay per hour?

As of Sep 4, 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.

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.
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Risk Adjustment Coding jobs near you
Infographic showing various Risk Adjustment Coding job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 89% Full Time, 8% Part Time, and 2% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $60,920 per year, or $29.3 per hour.

Senior Risk Adjustment Medical Coder - CRC

HealthPartners

Bloomington, MN • On-site

$32.31 - $48.47/hr

Full-time

Posted 18 days ago

HealthPartners rating

7.5

Company rating: 7.5 out of 10

Based on 138 frontline employees who took The Breakroom Quiz

232nd of 898 rated healthcare providers

Job description


HealthPartners is hiring a Risk Adjustment Coding Analyst Senior.
This position is responsible for diagnosis coding review and vendor coding quality assurance; working to ensure that plan performance and plan revenue is based on an accurate representation of our population's care needs and risks.
ACCOUNTABILITIES:
  1. Performs retrospective chart review for diagnosis coding accuracy.
  2. Identifies, analyzes, and reports coding error trends to inform risk adjustment analytics and deliver provider education.
  3. Reviews vendor coding and provide recurring feedback and education to vendor team.
  4. Participates in internal and CMS-mandated risk adjustment data validation review.
  5. Identifies, documents, and messages process improvements, clinical documentation improvements and/or other educational opportunities.
  6. Develops and performs training and educational seminars to physicians and advanced practice providers on risk adjustment topics.
  7. Increases collaborative efforts between HealthPartners Health Plan and HealthPartners Medical Group as it relates to optimization of diagnosis coding.
  8. Analyzes and organizes complex information for effective reporting to leadership.
  9. Conducts daily work consistent with HealthPartners core values and comply with all federal and state regulations.
  10. Maintains confidentiality of protected health information.
  11. Increases organizational efficiency in daily operations.
  12. Responsible for other duties as assigned.

REQUIRED QUALIFICATIONS:
  • High School Diploma or GED or Associate's degree in a related field
  • One of the following credentials required: RHIA, RHIT, CPC, CCS, CCS-P
  • Certified Risk Adjustment Coder (CRC) credential
  • Minimum of five years experience with diagnosis coding review as a certified coder
  • Demonstrated working knowledge of the revenue cycle process, claims processing, retrospective chart review process, compliance and federal/state regulations, CPT, ICD-9, and ICD-10 coding
  • Identify issues and formulate solutions relating to retrospective chart review process improvement initiatives
  • Understand and communicate clinical documentation requirements for correct coding and to ensure integrity of the medical record
  • Skill and experience in effectively collaborating with team members & others using oral, written and interpersonal communications
  • PC skills in Microsoft Word and Excel
  • Organize and prioritize multiple assignments
  • Ability to deal with change and ambiguity
  • Able to work, both, as a team member or independently

PREFERRED QUALIFICATIONS:
  • Four year college degree
  • Experience working with Epic

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