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Salaried Optum Health Coding Risk Adjustment Jobs in Texas

CommonSpirit Health

Value Based Coder II

Houston, TX

$18 - $23.75/hr

... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...

St Luke's Health

Value Based Coder II

Houston, TX

$25.30 - $35.74/hr

... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...

UTMB Health

Coder - RCO Coding (Remote)

Galveston, TX · Remote

$17.50 - $23.50/hr

RHIA - Registered Health Information Administrator (AHIMA) or * RHIT - Registered Health ... CRC - Certified Risk Adjustment Coder (AAPC) JOB SUMMARY: Properly codes and/or audits professional ...

Catholic Health Initiatives

Value Based Coder II

Houston, TX · On-site

$25.30 - $35.74/hr

... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...

St. Luke's Health

Value Based Coder II

Houston, TX · On-site +1

$25.30 - $35.74/hr

... health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and ...

UTMB Health

Coder - RCO Coding (Remote)

Galveston, TX · On-site +1

$17.50 - $23.50/hr

RHIA - Registered Health Information Administrator (AHIMA) or * RHIT - Registered Health ... CRC - Certified Risk Adjustment Coder (AAPC) JOB SUMMARY: Properly codes and/or audits professional ...

UTMB Health

Coder - RCO Coding (Remote)

Galveston, TX · Remote

$17.50 - $23.50/hr

RHIA - Registered Health Information Administrator (AHIMA) or * RHIT - Registered Health ... CRC - Certified Risk Adjustment Coder (AAPC) JOB SUMMARY: Properly codes and/or audits professional ...

Altegra Health

Remote Certified Coder

Dallas, TX · Remote

$22.25 - $30.50/hr

... Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from patient medical records. Assign ...

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All JobsSalaried Optum Health Coding Risk Adjustment JobsSalaried Optum Health Coding Risk Adjustment Jobs in Texas

Salaried Optum Health Coding Risk Adjustment information

What is a salaried Optum Health coding risk adjustment specialist?

A Salaried Optum Health Coding Risk Adjustment specialist is a healthcare professional employed by Optum Health who reviews medical records and codes diagnoses to ensure accurate risk adjustment. Their work supports proper reimbursement for Medicare Advantage and other risk-based health plans by identifying and coding chronic conditions and other relevant diagnoses. These specialists use their knowledge of ICD-10-CM coding guidelines and risk adjustment methodologies to improve documentation and compliance. Being salaried means they are full-time employees rather than contractors, which often includes benefits and consistent work schedules. Their efforts help ensure health plans are funded appropriately based on the health status of their members.

What are some common challenges faced by professionals in the salaried Optum Health coding risk adjustment role, and how can they be addressed?

One common challenge in the Salaried Optum Health Coding Risk Adjustment role is staying updated with frequent changes in coding guidelines, payer requirements, and risk adjustment models. Additionally, ensuring high accuracy while reviewing complex patient records under tight deadlines can be demanding. To address these challenges, professionals should engage in ongoing education, leverage available training resources provided by Optum, and actively participate in team knowledge-sharing sessions. Collaborating closely with clinical documentation specialists and auditing teams also helps maintain compliance and improve coding quality.

What are the key skills and qualifications needed to thrive as a salaried Optum Health coding risk adjustment specialist?

To excel as a Salaried Optum Health Coding Risk Adjustment specialist, you need a thorough understanding of ICD-10 coding, risk adjustment models, and healthcare compliance, typically supported by a coding certification such as CPC or CRC. Familiarity with electronic health record (EHR) systems, coding software, and data analytics tools is essential. Attention to detail, analytical thinking, and effective communication are vital soft skills for accurately interpreting clinical documentation and collaborating with healthcare teams. These competencies ensure accurate risk adjustment coding, regulatory compliance, and optimal reimbursement for healthcare organizations.

What is the difference between Salaried Optum Health Coding Risk Adjustment vs Medical Coder?

AspectSalaried Optum Health Coding Risk AdjustmentMedical Coder
CertificationsCPH, CCS, or RHIT often preferredCPH, CCS, or RHIT typically required
Work EnvironmentHealthcare organizations, insurance companies, remote optionsHospitals, clinics, outpatient facilities
Job FocusRisk adjustment coding, reimbursement accuracyClinical documentation, coding for billing
Industry UsageHigh in health insurance and managed careCommon in healthcare facilities

While both roles involve medical coding, Salaried Optum Health Coding Risk Adjustment specialists focus on risk adjustment coding to support insurance reimbursements, often working in managed care environments. Medical Coders typically handle clinical documentation coding for billing purposes in healthcare facilities. The roles share certifications and require strong coding skills but differ in their primary focus and work settings.

What are the most commonly searched types of Optum Health Coding Risk Adjustment jobs in Texas? The most popular types of Optum Health Coding Risk Adjustment jobs in Texas are:
What are popular job titles related to Salaried Optum Health Coding Risk Adjustment jobs in Texas? For Salaried Optum Health Coding Risk Adjustment jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Salaried Optum Health Coding Risk Adjustment jobs in Texas look for? The top searched job categories for Salaried Optum Health Coding Risk Adjustment jobs in Texas are:
What cities in Texas are hiring for Salaried Optum Health Coding Risk Adjustment jobs? Cities in Texas with the most Salaried Optum Health Coding Risk Adjustment job openings:
Salaried Optum Health Coding Risk Adjustment jobs near you

Value Based Coder II

CommonSpirit Health

Houston, TX

$18 - $23.75/hr

Full-time

Re-posted 21 days ago

CommonSpirit Health rating

7.0

Company rating: 7.0 out of 10

Based on 531 frontline employees who took The Breakroom Quiz

417th of 887 rated healthcare providers

Job description

Baylor St. Luke’s Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke’s Health. Located in the Texas Medical Center, the hospital is the home of the Texas Heart® Institute, a cardiovascular research and education institution founded in 1962 by Denton A. Cooley, MD. The hospital was the first facility in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award five consecutive times. Baylor St. Luke’s also has three community emergency centers offering adult and pediatric care for the Greater Houston area.


The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk-adjusting conditions and supporting provider documentation improvement.

1. Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC documentation and coding.
2. Advanced Documentation Improvement & Education: Analyze clinical documentation across the network to identify patterns, trends, and opportunities for improvement related to HCC capture. Develop and deliver effective education materials and tools to help network providers improve clinical documentation and support Hierarchical Condition Category coding capture. Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles.
3. Compliance & Regulatory Insight: Continuously monitor and interpret evolving HCC coding guidelines, CMS regulations, and compliance trends within the risk adjustment landscape, applying this knowledge to daily coding and education efforts. Champion a culture of compliance by advocating for best practices and providing robust provider support to ensure CommonSpirit adheres to all federal and coding guidelines pertaining to HCC and risk adjustment. Safeguard medical records and preserve the confidentiality of personal health information through adherence to all relevant policies (release of medical record information, record retention, HIPAA privacy and security).
4. Process Improvement & Collaboration: Actively participate in network performance improvement initiatives, offering insights and solutions based on coding expertise. Collaborate with providers and office staff to address documentation deficiencies and coding gaps.


2+ years of experience in outpatient coding
2+ years focused on risk adjustment and HCC principles.

Advanced knowledge of CPT and ICD-10 coding, with significant expertise in HCC codingguidelines and risk adjustment models.
Strong understanding of federal and state guidelines on all coding systems and sponsored programs.
Proficiency in developing and delivering educational content.
Effective interpersonal, communication, and presentation skills (both verbal and written).
Ability to manage multiple priorities and work independently.
Computer literacy in medical information systems, records management software, and encoder software.

Preferred/Desired Experience
4+ years of experience in outpatient coding,
3+ years focused on risk adjustment and HCC principles

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