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Risk Adjustment Coding Jobs (NOW HIRING)

Astrana Health Management

$70K - $85K/yr

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 ...

Insight Global

HCC Risk Adjustment Coder

Fort Worth, TX · Remote

$18 - $22/hr

Responsible for coding 2 Charts per hour. * Perform accurate HCC risk adjustment coding for Medicare populations * Review and code medical records in accordance with ICD and risk adjustment ...

Zing Health

Senior Risk Adjustment Coding Auditor

IL · Remote

$85K - $90K/yr

SUMMARY DESCRIPTION The Senior Risk Adjustment Coding Auditor is a highly experienced coding professional responsible for ensuring compliant, accurate, and high-quality risk adjustment coding across ...

Zing Health Holdings Inc

IL · On-site

$85K - $90K/yr

SUMMARY DESCRIPTION The Senior Risk Adjustment Coding Auditor is a highly experienced coding professional responsible for ensuring compliant, accurate, and high-quality risk adjustment coding across ...

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 ...

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 ...

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 ...

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Risk Adjustment Coding information

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How much do risk adjustment coding jobs pay per hour?

As of Sep 11, 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 September 2026, with employment types broken down into 1% As Needed, 90% Full Time, 7% Part Time, and 2% Contract. Highlights an 82% Physical, 5% Hybrid, and 13% Remote job distribution, with an average salary of $60,920 per year, or $29.3 per hour.

Risk Adjustment Coding Coordinator (onsite), full time, days

Holland, MI • On-site

Holland Hospital
See more jobs at Holland Hospitalexternal

$23.30 - $34.95/hr

Full-time

Re-posted 2 days ago

Holland Hospital rating

6.5

Company rating: 6.5 out of 10

Based on 33 frontline employees who took The Breakroom Quiz

Job description

CURRENT HOLLAND HOSPITAL EMPLOYEES- Please apply through Find Jobs from your Workday employee account.

The Coordinator will support Hierarchical Condition Category (HCC) coding risk adjustment initiatives across value-based care contracts by preparing medical records, performing documentation review, ensuring accurate capture of diagnosis codes, and educating providers. This role partners closely with providers, clinical staff, coding teams and operational leadership to optimize HCC capture and improve documentation integrity.
Qualifications:
Professional coding certification; Certified Risk Adjustment Coder (CRC) strongly preferred or required within 12 months of hire
Experience with risk adjustment programs preferred.
Prior provider education or clinical collaboration experience preferred.
Excellent communication skills for provider education and stakeholder collaboration

Employment Type: Full Time

Shift: Mon-Thrs- 8am-4:30pm Fri- 8a-12p

Weekly Scheduled Hours: 36

Wage Range: $23.30 - $34.95 per hour

Weekend Requirements: NA
Requirements:

- High school diploma/GED or higher education

-Certified Professional Coder (C-CPC)

Clinical Documentation Review & Risk Adjustment Coding

  • Prepare and manage risk adjustment visit workflows, including maintaining patient lists, diagnosis summaries, and assisting with scheduling coordination.
  • Conduct comprehensive previsit chart reviews to identify and validate ICD10-CM diagnoses that accurately represent each patient's health status.
  • Perform postvisit documentation analysis to ensure proper ICD10-CM code assignment, diagnosis specificity, and compliance with MEAT (Monitor, Evaluate, Assess, Treat) criteria.
  • Maintain uptodate knowledge of CMS risk adjustment regulations, HCC models, and clinical documentation and coding standards.
  • Support organizational value-based care goals by collaborating with Manager, Quality and clinical teams to ensure compliant risk adjustment documentation.

Provider Engagement, Education & Clinical Support

  • Serve as a clinical documentation and coding subject matter expert, supporting providers in achieving compliant and accurate risk adjustment practices.
  • Deliver ongoing education and feedback to providers and coders regarding documentation standards, diagnosis specificity, and optimal risk adjustment coding principles.
  • Identify documentation gaps or inconsistencies and communicate findings through structured, actionable feedback, including formalized documentation queries as needed.
  • Promote a culture of documentation excellence that supports quality outcomes, operational performance, and compliant value-based care delivery.

Audit, Reporting & Performance Monitoring

  • Conduct routine and targeted chart audits to assess documentation quality, coding accuracy, and HCC recapture performance.
  • Track, analyze, and report key risk adjustment performance indicators, including recapture rates, suspect condition closure, documentation accuracy, and provider-level trends.
  • Collaborate with operational leaders to integrate risk adjustment best practices into existing clinical workflows and identify opportunities for process improvement.
  • Participate in quality assurance initiatives, report findings to leadership, and support the development of corrective action plans or workflow enhancements.

Holland Hospital is an Equal Opportunity Employer, please see our EEO policy

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