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$35K

$60.6K

$90.5K

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

As of Jun 10, 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.

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Salaried Optum Health Coding Risk Adjustment jobs near you
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 100% Full Time. Highlights an 79% Physical, 4% Hybrid, and 17% Remote job distribution, with an average salary of $60,634 per year, or $29.2 per hour.
Ambulatory Risk Adjustment Coding Specialist

Ambulatory Risk Adjustment Coding Specialist

NorthShore

Skokie, IL • On-site

$22.14 - $33.21/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Hourly Pay Range:
$22.14 - $33.21 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Position Highlights:
  • Position: Ambulatory Risk Adjustment Coding Specialist
  • Location: Skokie, IL
  • Full Time
  • Hours: Monday-Friday, [hours and flexible work schedules]

A Brief Overview:
Our ambulatory risk adjustment coding specialist I plays a key role in identifying HCC codes within physician outpatient visits and ensuring they are coded accurately and to the highest specificity. They additionally will verify that documentation requirements are met to validate the HCC diagnosis code. Working closely with the ambulatory clinical documentation specialist (CDS), they will clinically verify the accuracy of HCC codes. Using compliant query guidelines, the coding specialist will query the physician should documentation need clarification or specification. The coding specialist is expected to maintain current knowledge of the ICD-10-CM codes and guidelines and meet minimum productivity requirements outlined by team leadership.
What you will do:
  • Review/abstract HCC codes to ensure they are coded accurately, to the highest specificity possible, and make sure the required MEAT is documented, resulting in the correct CMS-HCC risk score
  • Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education
  • Responsible for partnering with ambulatory clinical documentation specialists and physicians to properly code patient charts to ensure appropriate risk adjustment
  • Assist coding leadership by making recommendations for process improvements to further enhance coding goals and outcomes
  • Assists the coding team leads with onboarding new coding specialists to the role as needed.
  • Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations
  • Consistently maintain a minimum 95% accuracy on coding quality audits
  • Meet minimum productivity requirements as outlined by the project terms
  • Utilizes technical coding expertise to assign appropriate ICD-10-CM diagnosis codes, as well as assist in appropriate assignment of risk adjustment
  • Maintains advanced knowledge of coding all HCC diagnoses from the medical record in accordance with the ICD-10-CM coding guidelines
  • Assists with and completes special project work as assigned by Ambulatory Clinical Documentation Leadership

What you will need:
  • Education: High School Required or Associates Degree Preferred
  • Experience 2 years experience working in healthcare or in a professional business environment
  • Certification: Certified Risk Adjustment Coder (CRC) certification required within 6 months of hire

Benefits (For full time or part time positions):
  • Premium pay such as shift, on call, holiday and more based on an employee's job (For eligible positions)
  • Incentive pay for select positions
  • Opportunity for annual increases based on performance
  • Career Pathways to Promote Professional Growth and Development
  • Various Medical, Dental, Pet and Vision options
  • Tuition Reimbursement
  • Free Parking
  • Wellness Program Savings Plan
  • Health Savings Account Options
  • Retirement Options with Company Match
  • Paid Time Off and Holiday Pay
  • Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit www.endeavorhealth.org.
When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.
Please explore our website (www.endeavorhealth.org) to better understand how Endeavor Health delivers on its mission to "help everyone in our communities be their best".
Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.
At Endeavor Health, we are united by a shared commitment to working together to create a culture of connection and belonging-each of us bringing different skills and experiences as we deliver safe, seamless, and personal care. Every person, every time. We are committed to fostering an environment where all team members can be their best, learn, and pursue excellence together.
EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.

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