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Risk Adjustment Provider Educator Jobs (NOW HIRING)

TEKsystems

Risk Adjustment Coding Auditor

Phoenix, AZ · Remote

$32 - $37/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Provider education experience. * Risk Adjustment Data Validation (RADV) experience. * CPMA or additional coding credentials. * Experience with NLP (Natural Language Processing) software. * RHIT or ...

MetroPlusHealth

Risk Adjustment Specialist

Manhattan, NY · On-site

$72K - $82K/yr

Access and analyze data within the enterprise data warehouse to evaluate member, provider, claims ... Required Education, Training & Professional Experience * Bachelor's degree required, with a ...

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Risk Adjustment Provider Educator information

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How much do risk adjustment provider educator jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for risk adjustment provider educator in the United States is $43.95, according to ZipRecruiter salary data. Most workers in this role earn between $33.65 and $52.40 per hour, depending on experience, location, and employer.

What is a risk adjustment provider educator?

A Risk Adjustment Provider Educator is a healthcare professional who trains and supports medical providers on proper documentation and coding practices for risk adjustment programs. These educators help ensure that providers accurately capture patient diagnoses, which affects health plan payments and compliance with regulatory requirements. Their role is essential in promoting accurate risk scores, improving quality of care, and minimizing potential errors in coding and documentation. They may also review medical records, provide feedback, and conduct educational sessions for providers and staff.

What are the key skills and qualifications needed to thrive as a risk adjustment provider educator?

To thrive as a Risk Adjustment Provider Educator, you need in-depth knowledge of risk adjustment methodologies, coding guidelines (such as ICD-10-CM), and healthcare regulations, typically supported by a clinical or coding certification (e.g., CPC, CRC, CCS). Familiarity with electronic health record (EHR) systems, coding software, and data analytics tools is crucial. Strong communication, presentation, and interpersonal skills help educate and engage providers effectively. These competencies ensure accurate documentation, compliance, and optimized risk adjustment outcomes for healthcare organizations.

What are some typical challenges faced by a risk adjustment provider educator, and how can they be addressed?

Risk Adjustment Provider Educators often face challenges such as ensuring providers understand complex coding requirements, maintaining engagement during training sessions, and keeping up with frequent regulatory updates. To address these challenges, educators can use clear, real-world examples, interactive training methods, and ongoing communication to reinforce key concepts. Collaborating closely with coding and compliance teams also helps educators stay current and provide the most accurate guidance to providers.

What is the difference between Risk Adjustment Provider Educator vs Risk Adjustment Coding Specialist?

AspectRisk Adjustment Provider EducatorRisk Adjustment Coding Specialist
CredentialsCertifications in risk adjustment, healthcare educationCertifications in medical coding, CPC or CCS
Work EnvironmentTraining sessions, educational programs, provider officesMedical offices, coding departments, billing teams
Employer & IndustryHealth plans, provider organizations, healthcare education firmsHospitals, clinics, billing companies

While both roles focus on risk adjustment, the Risk Adjustment Provider Educator primarily trains healthcare providers on documentation and compliance, whereas the Risk Adjustment Coding Specialist concentrates on accurate medical coding to support risk adjustment calculations. The educator role emphasizes teaching and communication, while the coding specialist focuses on detailed coding accuracy.

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Risk Adjustment Provider Educator jobs near you
Infographic showing various Risk Adjustment Provider Educator job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 77% Full Time, 14% Part Time, and 6% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $91,418 per year, or $44 per hour.

HEALTH CODER - HCC & RISK ADJUSTMENT

North East Medical Services

Burlingame, CA • On-site

$42.79 - $48.75/hr

Other

Re-posted 2 days ago

Job description

Health Coder - Hcc & Risk Adjustment

Burlingame, CA 94010

Overview

Salary Range $42.79 - $48.75 Hourly

Description

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance.

Essential Job Functions:

  • Hcc Coding and Risk Adjustment (Ra) Program Support
    • Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with Hcc and risk adjustment guidelines.
    • Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
    • Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
  • Provider Training and Clinical Documentation Improvement (Cdi)
  • Develop and deliver provider education sessions and materials on best practices for clinical documentation and Hcc/Ra coding.
  • Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
  • Serve as a resource and subject matter expert on Hcc, risk adjustment, and related coding standards.
  • Data Analysis and Reporting
    • Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
    • Generate reports and dashboards to track coding performance and documentation accuracy.
    • Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
  • Compliance and Continuous Improvement
    • Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
    • Assist in the development and implementation of internal coding policies and procedures.
    • Participate in quality improvement initiatives related to coding and documentation.
    • Performs other job duties as required by manager/supervisor
Qualifications
  • Education & Certification
    • Bs/Ba Degree in Health Science or General Education is required.
    • Certified Professional Coder (Cpc), Certified Risk Adjustment Coder (Crc), or equivalent coding certification is required.
    • Additional Cdi or auditing certifications (Ccds, Cdeo, Cpma) are preferred.
  • Experience
    • Minimum of 3 years of experience in medical coding with a focus on Hcc, risk adjustment, and Medicare Advantage programs.
    • Experience in provider education, clinical documentation improvement (Cdi), and chart audits.
    • Previous experience working in an Ipa, managed care organization, or similar setting is strongly preferred.
  • Skills & Competencies
    • Excellent communication, presentation, and interpersonal skills.
    • Strong understanding of Cms guidelines for Medicare Advantage and risk adjustment program.
    • Exceptional knowledge of Icd-10-Cm coding and Hcc risk adjustment coding methodologies.
    • Proficiency in electronic health records (Ehr) and coding software.
    • Strong analytical and problem-solving skills.

Language:

  • Must be able to fluently speak, read and write English.
  • Fluency in other languages is an asset.

Status:

  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This a full-time position.

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