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Salaried Optum Health Coding Risk Adjustment Jobs in Riverside, CA

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Salaried Optum Health Coding Risk Adjustment information

See Riverside, CA salary details

$36.5K

$63.3K

$94.4K

How much do salaried optum health coding risk adjustment jobs pay per year?

As of Jun 15, 2026, the average yearly pay for salaried optum health coding risk adjustment in Riverside, CA is $63,257.00, according to ZipRecruiter salary data. Most workers in this role earn between $50,100.00 and $76,200.00 per year, depending on experience, location, and employer.

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, and why are they important?

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 popular job titles related to Salaried Optum Health Coding Risk Adjustment jobs in Riverside, CA? For Salaried Optum Health Coding Risk Adjustment jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Salaried Optum Health Coding Risk Adjustment jobs in Riverside, CA look for? The top searched job categories for Salaried Optum Health Coding Risk Adjustment jobs in Riverside, CA are:
Salaried Optum Health Coding Risk Adjustment jobs near you
Infographic showing various Salaried Optum Health Coding Risk Adjustment job openings in Riverside, CA as of June 2026, with employment types broken down into 8% As Needed, 84% Full Time, and 8% Part Time. Highlights an 92% In-person, and 8% Remote job distribution, with an average salary of $63,257 per year, or $30.4 per hour.

Health Risk Adjustment Coder

Blue Zones Health

Riverside, CA • On-site

$70K - $90K/yr

Full-time

Posted 5 days ago

Job description

Description:

You could be the one who changes everything.

Blue Zones Health is on a mission to empower patients, physicians, and communities to Live Better, Longer™ by delivering transformative primary care rooted in lifestyle medicine. Formerly Healthly, we are reimagining healthcare by addressing the root causes of chronic disease and reducing the need for costly interventions. Our approach integrates insights from the original Blue Zones research, over 25 years of scientific study into the world’s longest-lived cultures, and is grounded in the evidence-based methodology of the American College of Lifestyle Medicine.

We serve patients virtually nationwide and in-person through an expanding network of clinic locations, making whole-person care accessible and impactful.

Position Summary

The Health Risk Adjustment Coder plays a vital role on the Blue Zones Health Vitality Medical Team. This individual owns risk adjustment strategy implementation, partner relationships, compliance, and quality performance initiatives related to Medicare Risk Adjustment (MRA). The role focuses on the development and oversight of data-driven programs that support accurate coding, provider engagement, performance improvement, and regulatory compliance.


This is a remote position with local travel required 2–3 times per week to provider practices across the all provider network region.

Key Responsibilities

  • Serve as the subject matter expert (SME) and lead initiatives across prospective, retrospective, and concurrent MRA strategies.
  • Monitor risk adjustment coding compliance and performance across the organization.
  • Guide provider documentation, chart review accuracy, and coding integrity to ensure appropriate HCC recapture.
  • Conduct internal education for clinical staff and providers on accurate coding practices and clinical documentation improvement.
  • Lead cross-functional collaboration with Finance, Analytics, and the Vitality team to identify coding improvement opportunities and drive data-informed strategies.
  • Partner with vendors and payers to oversee coding performance, program integrity, and service level adherence.
  • Drive completion of key KPIs, including risk score accuracy, coding quality, and annual wellness visit (AWV) completion rates.
  • Support operational leaders and provider engagement teams with workflow integration and training for value-based risk and quality initiatives.
  • Support tailored campaign strategies for risk and quality performance improvement based on local market needs and provider group trends.
  • Ensure all activities meet federal, state, and partner compliance requirements.
  • Provide regular updates and progress reports to senior leadership and key stakeholders.

Compliance:

  • Employee shall comply with all applicable federal, state, and local laws, as well as all Employer policies, procedures, and standards, including but not limited to codes of conduct and ethics requirements, as amended from time to time.
Requirements:

Licensure & Certification (one or more required):

  • Certified Professional Coder (CPC) – AAPC
  • Certified Risk Adjustment Coder (CRC) – AAPC
  • Certified Coding Specialist for Providers (CCS-P) – AHIMA
  • Registered Health Information Technician (RHIT) – AHIMA

Experience:

  • Minimum 2 years in medical operations, specifically within value-based care and risk adjustment coding.
  • Demonstrated knowledge of Medicare Advantage, RAF scores, and risk score documentation.
  • Prior experience educating providers on correct coding and care gap closure.
  • Strong project management and performance tracking skills.

Skills and Competencies

  • Proficient in MS Office Suite (Excel, Word, PowerPoint).
  • Strong analytical thinking, public speaking, and written communication skills.
  • Ability to synthesize data and translate trends into actionable strategies.
  • Skilled at building relationships and working cross-functionally.
  • Experience presenting coding performance trends to physician groups or leadership.
  • Self-directed, detail-oriented, and able to manage multiple priorities effectively.

Working Conditions

  • Remote work with local travel to clinics in the All-provider network coverage at least 2–3 days per week. Rotation of clinics will be flexible
  • Normal office working conditions with flexibility in scheduling.
  • Must have reliable transportation and the ability to travel within the assigned region.