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Risk Adjustment Jobs (NOW HIRING)

Vytwo

Risk Adjustment Coding Auditor

Prosper, TX · 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'

Harris Health System

Risk Adjustment Coder II

Houston, TX · 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 ...

Centrum Health

Risk Adjustment Data Analyst

Doral, FL · On-site

The Risk Adjustment Analyst will be the lead in the design, implementation, and maintenance of all Risk Adjustment and Quality Data and Dashboards for our entire NeueHealth Portfolio: ACA, Medicare ...

Harris Health System

Risk Adjustment Coder II

Houston, TX · 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 ...

Stanford Health Care

Sr Risk Adjustment Coder

Newark, NJ · 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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How much do risk adjustment jobs pay per hour?

As of Sep 1, 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.

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.

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 long does it take to become a risk adjustment coder?

Becoming a risk adjustment coder typically requires completing a specialized training program or certification, which can take from a few months up to a year. Many professionals also pursue coding certifications such as CPC or CCS to enhance their skills and job prospects, with experience in medical coding and understanding of health records being important for success.
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Risk Adjustment jobs near you
Infographic showing various Risk Adjustment 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 $63,100 per year, or $30.3 per hour.

CDI & Risk Adjustment Specialist

Phoenix, AZ

Hospice of the Valley

7.8

Company rating: 7.8 out of 10

Based on 24 frontline employees who took The Breakroom Quiz

11th of 47 rated hospices

Great coworkers

People enjoy working here

Good employer

Learn more about Hospice of the Valleyexternal

$33 - $44.25/hr

Full-time

PTO

Posted 18 days ago

Job description

Join Arizona’s largest, most prominent not-for-profit hospice, serving the valley since 1977.

Hospice of the Valley is a national leader in hospice care and has been serving the Phoenix metropolitan area since 1977.  A mission-driven, not-for-profit organization, Hospice of the Valley employs compassionate, skilled professionals who are committed to excellence, enjoy teamwork, and contribute daily to our mission and culture of caring. Team members experience a friendly, supportive atmosphere, leadership support, autonomy, flexibility and the privilege of doing meaningful, rewarding work.

Benefits:

  • Supportive work environment with a culture of caring for patients and one another.
  • Competitive wages and excellent benefit program.
  • Generous Paid Time Off.
  • Flexible schedules for work/life balance

Position Profile

The CDI & Risk Adjustment Specialist is responsible for strengthening clinical documentation integrity, improving risk adjustment accuracy, and supporting reliable coding outcomes across the patient population. This senior individual contributor role carries primary accountability for ensuring documentation accurately reflects patient complexity, severity of illness, and applicable risk adjustment requirements. The role serves as a critical link between clinical care, documentation standards, and accurate coding through comprehensive chart review, provider collaboration, and targeted education.

Responsibilities

  • Promotes clinical documentation integrity and accurate coding outcomes.
  • Facilitates provider query, collaboration, and clarification.
  • Conducts quality chart review and audits.
  • Promotes provider education and documentation improvement.
  • Facilitates continuous improvement and assures compliance with documentation and risk adjustment requirements.
  • Strong verbal and written communication skills, including the ability to explain documentation and coding concepts clearly and professionally.
  • High proficiency in Electronic Health Record (EHR) platforms and data analytic tools.
  • Ability to build effective working relationships with providers, clinical staff, coders, compliance partners, and operational leaders.
  • Strong analytical skills with the ability to interpret clinical information, identify documentation gaps, and evaluate coding support.
  • High attention to detail, accuracy, confidentiality, and follow-through.
  • Ability to organize work, manage competing priorities, meet deadlines, and perform independently as a senior individual contributor.

Minimum Qualifications

  • Bachelor’s degree in nursing, health information management, healthcare administration, coding, or a related healthcare field preferred; equivalent relevant experience may be considered.
  • Minimum of 3–5 years dedicated experience in clinical documentation integrity, risk adjustment, and HCC coding.
  • Certified Risk Adjustment Coder (CRC) designation from the AAPC required.
  • Experience reviewing medical records for documentation specificity, diagnosis support, coding accuracy, and risk adjustment opportunity identification.
  • Deep understanding of CMS risk adjustment models, HCC categories, ICD-10-CM coding concepts, clinical documentation standards, and provider query practices.
  • Expertise in use of Chronic Care Management and Principal Care Management Codes.
  • Strong clinical knowledge of anatomy, physiology, and pharmacology to effectively evaluate disease progression.

Preferred Qualifications

  • Experience collaborating with providers, clinical leaders, coders, compliance teams, or revenue cycle teams.
  • Registered Nurse.
  • Additional certifications such as CCDS (Certified Clinical Documentation Specialist) or CDIP (Certified Documentation Improvement Practitioner.)

 Hospice of the Valley is an equal employment opportunity employer. EOE/M/F/D/V

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