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Risk Adjustment Jobs (NOW HIRING)

We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...

Job Summary Provides audit support for Molina enterprise risk adjustment activities. Responsible for developing, recommending and implementing controls and cost-effective approaches to minimize the ...

Risk Adjustment Coding Auditor

Prosper, TX ยท On-site

$25 - $28.50/hr

Risk Adjustment Coding Auditor Quantity of resources: 2 Duration: 6 months JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV'

Risk Adjustment Coding Auditor

Prosper, TX ยท On-site

$25 - $28.50/hr

Risk Adjustment Coding Auditor Quantity of resources: 2 Duration: 6 months JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV'

Risk Adjustment Coder II

Houston, TX ยท On-site

$27.69 - $34.61/hr

Job Profile JOB SUMMARY The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a ...

Risk Adjustment Coder II

Houston, TX ยท On-site

$27.69 - $34.61/hr

Job Profile JOB SUMMARY The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a ...

Risk Adjustment Coder II

Houston, TX ยท On-site

$18 - $23.75/hr

Job Profile JOB SUMMARY The Risk Adjustment Coder II provides advanced support for complex medical record reviews to ensure the correct capture of chronic conditions and complexities to calculate a ...

Sr Risk Adjustment Coder

Newark, NJ ยท On-site

$44.13 - $57.36/hr

Risk Adjustment Review * May perform prospective and concurrent Clinical Documentation Improvement (CDI) workflows as well as retrospective auditing * Reviewing medical records to ensure accurate HCC ...

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Risk Adjustment information

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How much do risk adjustment jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for risk adjustment in the United States is $30.34, according to ZipRecruiter salary data. Most workers in this role earn between $19.47 and $38.70 per hour, depending on experience, location, and employer.

What is risk adjustment?

Risk adjustment is a statistical process used in healthcare to account for the underlying health status and related costs of patients when comparing outcomes or setting payments. It helps ensure that providers or health plans are fairly compensated for caring for sicker patients and prevents them from being penalized for taking on higher-risk individuals. By considering factors such as age, gender, and chronic conditions, risk adjustment creates a more level playing field and promotes quality care across diverse populations.

What is the difference between Risk Adjustment vs Coding Specialist?

AspectRisk AdjustmentCoding Specialist
Required CredentialsCertifications like RHIA, RHIT, or CCS; knowledge of risk modelsCertifications such as CPC, CCS; coding accuracy skills
Work EnvironmentHealthcare organizations, insurance companies, risk adjustment teamsHospitals, clinics, medical billing departments
Industry UsageUsed to adjust payments based on patient risk profilesUsed to translate medical records into billing codes
Common Search/ComparisonOften compared for roles in healthcare finance and reimbursementCompared for medical coding and billing roles

Risk Adjustment professionals focus on analyzing patient data to ensure accurate risk scores for reimbursement, while Coding Specialists translate medical records into standardized codes for billing. Both roles require healthcare knowledge but serve different functions within the healthcare revenue cycle.

How does a risk adjustment professional typically collaborate with other departments to ensure accurate data capture and reporting?

Risk Adjustment professionals frequently work cross-functionally with coding specialists, data analysts, and clinicians to ensure that patient diagnoses and health records are accurately documented and coded. This collaboration often involves regular meetings to review medical records, resolve discrepancies, and discuss updates in coding guidelines. By working closely with these teams, Risk Adjustment staff help ensure compliance with industry standards and maximize reimbursement accuracy, all while improving the quality of patient data. Strong communication and teamwork skills are essential in this role to effectively bridge gaps between clinical and administrative functions.

What are the key skills and qualifications needed to thrive as a risk adjustment specialist, and why are they important?

To thrive as a Risk Adjustment Specialist, you need a strong understanding of medical coding (ICD-10), healthcare regulations, and data analysis, often supported by a degree in health information management or a related field. Familiarity with coding software, EHR systems, and certifications such as CRC (Certified Risk Adjustment Coder) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for accurately interpreting medical records and collaborating with providers. These skills and qualifications are essential to ensure accurate risk scoring, regulatory compliance, and proper reimbursement in the healthcare system.
More about Risk Adjustment jobs
What cities are hiring for Risk Adjustment jobs? Cities with the most Risk Adjustment job openings:
What are the most commonly searched types of Risk Adjustment jobs? The most popular types of Risk Adjustment jobs are:
What states have the most Risk Adjustment jobs? States with the most job openings for Risk Adjustment jobs include:
Infographic showing various Risk Adjustment job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 88% Full Time, 8% Part Time, and 3% Contract. Highlights an 88% Physical, 5% Hybrid, and 7% Remote job distribution, with an average salary of $63,100 per year, or $30.3 per hour.

Risk Adjustment Coding Auditor

ClinDCast LLC

Albany, NY โ€ข Remote

$30 - $35/hr

Full-time

Re-posted yesterday


Job description

Job Summary:
We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must be CPC and CRC certified with strong risk adjustment coding expertise and proficiency in Microsoft Office Suite.
Required Skills:
8+ years of Risk Adjustment coding and auditing experience
Experience supporting CMS RADV first- and second-pass audits
Active CPC (Certified Professional Coder) certification
Active CRC (Certified Risk Adjustment Coder) certification
Proficiency in Microsoft Office Suite (Excel, Word, Outlook)

This is a remote position.


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About ClinDCast

Sourced by ZipRecruiter

ClinDCast is at the forefront of shaping the future of healthcare by partnering with globally recognized healthcare organizations and offering them innovative solutions and expert guidance. Our suite of services is designed to cater to a broad range of needs of healthcare organizations, including healthcare IT innovation, electronic health record (EHR) implementation & optimizations, data conversion, regulatory and quality reporting, enterprise data analytics, FHIR interoperability strategy, payer-to-payer data exchange, and application programming interface (API) strategy. With 15+ Years Of Healthcare IT Industry Experience, ClinDCast Is A Trusted Partner For Payers, Providers, And Lifesciences Organizations, Enabling Them To Deliver Exceptional Product And Solutions For Their Customers.

Industry

Health care and social assistance

Company size

11 - 50 Employees

Headquarters location

Wesley Chapel, FL, US

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