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Salaried Optum Health Coding Risk Adjustment Jobs

Ability to act as a coding resource or QA resource for Medicare Risk Adjustment, Commercial Risk Adjustment and Medicaid when production volume is required. * Excellent written and verbal skills ...

Ability to act as a coding resource or QA resource for Medicare Risk Adjustment, Commercial Risk Adjustment and Medicaid when production volume is required. * Excellent written and verbal skills ...

Auditor, Risk Adjustment

Miami, FL · Remote

$82K - $108K/yr

Oscar is the first health insurance company built around a full stack technology platform and a ... Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ...

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Salaried Optum Health Coding Risk Adjustment information

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$35K

$60.6K

$90.5K

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

As of Jul 3, 2026, the average yearly pay for salaried optum health coding risk adjustment in the United States is $60,634.00, according to ZipRecruiter salary data. Most workers in this role earn between $48,000.00 and $73,000.00 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.

More about Salaried Optum Health Coding Risk Adjustment jobs
What cities are hiring for Salaried Optum Health Coding Risk Adjustment jobs? Cities with the most Salaried Optum Health Coding Risk Adjustment job openings:
What are the most commonly searched types of Optum Health Coding Risk Adjustment jobs? The most popular types of Optum Health Coding Risk Adjustment jobs are:
What states have the most Salaried Optum Health Coding Risk Adjustment jobs? States with the most job openings for Salaried Optum Health Coding Risk Adjustment jobs include:
Infographic showing various Salaried Optum Health Coding Risk Adjustment job openings in the United States as of June 2026, with employment types broken down into 54% Full Time, 35% Part Time, 7% Temporary, 3% Contract, and 1% Summer. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $60,634 per year, or $29.2 per hour.
Coding Manager (Risk Adjustment)

Coding Manager (Risk Adjustment)

Cotiviti

On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 16 days ago


Cotiviti rating

8.3

Company rating: 8.3 out of 10

Based on 33 frontline employees who took The Breakroom Quiz

40th of 207 rated it services


Job description

Overview

The Coding Manager leads a team of coders, directly or indirectly, to deliver key components to the Cotiviti coding program. This role works with the Director of Coding, the Client team and other areas related to production, QA, and analytics for oversight of ongoing production and quality accuracy.

Responsibilities
  • Work with the Director, Coding Services to oversee CMS-HCC and HHS- HCC coding production and quality including the management of staff, hiring, promoting, evaluating, and training, disciplining, and mentoring at the client team level.
  • Facilitates all production meetings with Reporting, Data Capacity operations planning, and leadership to develop coding and abstraction production plans. Communicates production plans, quality goals and project priorities to internal Coding teams as well as external vendor partners in preparation for on-boarding and/or scheduling of all client projects, including on and offshore coding.
  • Resolve issues that impact coding production and the full utilization of coding abstraction services for MRA, CRA and Medicaid. This will involve working closely with chart retrieval staff, IT, Production Analytics, HR, Trainers, and the QA team.
  • Utilize Coding forecast and coding output data to monitor coding productivity and quality; address coders work performance concerns through meeting with the Coder and/or coding vendor leadership to develop an action plan as needed regarding production and quality accuracy standards.  This includes the development of monitoring tools as needed to continually assess staff progress toward goal achievement.
  • Constructs and communicates internal system reports for all coders (Coder I, Coder II, QA I and QA II and Team Leads) in the Clinical Coding Department. These reports cross production and quality accuracy. Reports are reviewed daily, weekly, monthly, quarterly, and yearly as needed.
  • Ensures completion of various chart types (physician, hospital outpatient, hospital inpatient) from both a production and quality accuracy perspective.
  • Frequently meets with clients to provide meaningful updates on project progress; works closely with client success and coding quality to ensure successful deliverables.
  • Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction.
  • Complete all responsibilities as outlined in the annual performance review and/or goal setting.
  • Complete all special projects and other duties as assigned.
  • Must be able to perform duties with or without reasonable accommodation.

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change.

Qualifications
  • Bachelor's degree, Coding certification; RHIA, RHIT, CRC, CCS, CCS-P, CPC, CPC-H (Nationally certified medical coder as certified by either AAPC or AHIMA) or 4 years equivalent work experience.
  • 5+ years of HCC medical coding, record abstraction experience, including supervisory experience.
  • Ability to establish, monitor and enforce staffing schedules and production schedules.
  • Ability to analyze data to identify trends, outliers or areas that need attention from both a production and quality perspective, and implement changes as needed.
  • Ability to act as a coding resource or QA resource for Medicare Risk Adjustment, Commercial Risk Adjustment and Medicaid when production volume is required.
  • Excellent written and verbal skills including coaching and interpersonal skills, and client interaction.
  • Strong knowledge of medical terminology and anatomy and physiology.
  • Analytical and critical thinking skills to understand data to influence decision making.
  • Computer and technology literate.
  • Manage multiple client deliverables and competing deadlines simultaneously.
  • Awareness and adherence to HIPAA privacy and security regulations.
  • Must remain flexible to provide assistance in any emergent situations and/or projects.
  • Must be able to perform duties with or without reasonable accommodation.
  • Work is performed in an office setting with some possible travel.

Mental Requirements:

  • Communicating with others to exchange information.
  • Assessing the accuracy, neatness, and thoroughness of the work assigned.

Physical Requirements and Working Conditions:

  • Remaining in a stationary position, often standing or sitting for prolonged periods.
  • Repeating motions that may include the wrists, hands, and/or fingers.
  • Must be able to provide a dedicated, secure work area.
  • Must be able to provide high-speed internet access/connectivity and office setup and maintenance.

Base compensation ranges from $82,000 to $102,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. 

Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.

Date of posting: 6/15/2026

Applications are assessed on a rolling basis. We anticipate that the application window will close on 8/30/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.

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#LI-RemoteEmployment Type: OTHER

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