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$17

$29

$70

How much do seasonal optum health coding risk adjustment jobs pay per hour?

As of Jun 7, 2026, the average hourly pay for seasonal optum health coding risk adjustment in the United States is $29.29, according to ZipRecruiter salary data. Most workers in this role earn between $21.88 and $29.09 per hour, depending on experience, location, and employer.

What are some common challenges faced by Seasonal Optum Health Coding Risk Adjustment professionals, and how can they be managed?

Seasonal Optum Health Coding Risk Adjustment professionals often encounter challenges such as handling high volumes of medical records within tight deadlines and ensuring coding accuracy to meet regulatory standards. Staying up-to-date with frequent coding guideline changes and adapting quickly to new technologies or platforms are also common hurdles. To manage these challenges, it's helpful to establish efficient workflows, participate in ongoing training, and maintain open communication with team members and supervisors for clarification or support.

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

AspectSeasonal Optum Health Coding Risk AdjustmentMedical Coder
CertificationsCPHQ, CPC, or CCS often preferredCPC, CCS, or equivalent certifications
Work EnvironmentHealthcare insurance, risk adjustment teams, remote or office-basedHospitals, clinics, or insurance companies, often office-based
Job FocusAnalyzing and coding health data for risk adjustment, seasonal workload peaksAssigning medical codes to patient records for billing and documentation

Seasonal Optum Health Coding Risk Adjustment specialists focus on analyzing health data for risk adjustment, often during peak seasons, requiring specific certifications. Medical Coders primarily assign codes to medical records for billing, working in various healthcare settings. While both roles involve medical coding, their focus, environment, and seasonal demands differ significantly.

What are the key skills and qualifications needed to thrive as a Seasonal Optum Health Coding Risk Adjustment Specialist, and why are they important?

To excel as a Seasonal Optum Health Coding Risk Adjustment Specialist, you need expertise in medical coding (preferably with a CPC, CRC, or CCS certification), a solid understanding of ICD-10 guidelines, and knowledge of risk adjustment methodologies. Familiarity with electronic health record (EHR) systems, coding software, and Optum's proprietary platforms is typically required. Attention to detail, analytical thinking, and effective communication are essential soft skills for accurately interpreting clinical documentation and collaborating with healthcare teams. These competencies are crucial to ensure precise coding, regulatory compliance, and optimal reimbursement for healthcare organizations.

What is a Seasonal Optum Health Coding Risk Adjustment position?

A Seasonal Optum Health Coding Risk Adjustment position involves reviewing medical records and coding diagnoses for risk adjustment purposes, typically during peak times of the year. These professionals help ensure that patient health conditions are accurately documented and coded according to regulatory guidelines. This role supports healthcare organizations in receiving proper reimbursement and maintaining compliance. Seasonal positions are usually temporary, aligning with periods of increased workload, such as annual data submissions.
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Seasonal Optum Health Coding Risk Adjustment jobs near you
Infographic showing various Seasonal Optum Health Coding Risk Adjustment job openings in the United States as of May 2026, with employment types broken down into 14% Internship, 43% Full Time, 14% Contract, and 29% Nights. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $60,920 per year, or $29.3 per hour.

Risk Adjustment Specialist

LSMA Management Inc

San Bernardino, CA • On-site, Remote

$30 - $34/hr

Other

Posted 23 days ago

Job description

Description

JOB SUMMARY

The Risk Adjustment Specialist - Coding Compliance supports the organization's delegated Risk Adjustment and Coding Compliance programs by performing specialized audit support, documentation review coordination, coding validation support, medical record analysis, and compliance activities to promote accurate and complete Hierarchical Condition Category (HCC) capture in accordance with Centers for Medicare & Medicaid Services (CMS), California Department of Managed Health Care (DMHC), National Committee for Quality Assurance (NCQA), Office of Inspector General (OIG), and contracted health plan requirements.

This role supports coding compliance oversight activities related to Medicare Advantage Risk Adjustment, Risk Adjustment Data Validation (RADV), provider documentation integrity, and coding accuracy initiatives. The position assists with identifying documentation gaps, monitoring coding compliance trends, coordinating audit preparation activities, and supporting provider education efforts to ensure accurate Risk Adjustment Factor (RAF) scoring and regulatory compliance.

The Risk Adjustment Specialist collaborates closely with Coding Compliance leadership, certified coders, providers, population health teams, utilization management, care management, quality improvement, and health plans to support compliant documentation and coding practices, audit readiness, and delegated risk adjustment program performance.

Requirements

MINIMUM & PREFERRED QUALIFICATIONS:


Education/Training

Minimum: High school diploma or GED equivalent required

Preferred: Associate's degree or higher in healthcare administration, public health, social services, or related field. 

Experience 

Minimum: At least one year of experience in one or more of the following areas: risk adjustment, coding compliance, medical record review, managed care, healthcare administration, managed care or MSO environment, medical office or provider operations.

Preferred: Experience supporting Medicare Advantage Risk Adjustment programs. Experience supporting CMS RADV audits or coding compliance audits. Experience in an MSO, IPA, health plan, delegated entity, or managed care environment. Experience working with electronic health records, coding software, or Risk Adjustment platforms.

Certification(s)

Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or other coding certification preferred.

Skills, Knowledge & Abilities

  • Knowledge of CMS Risk Adjustment methodology, HCC documentation requirements, and RAF score principles. 
  • Understanding of Medicare Advantage Risk Adjustment, coding compliance, and documentation integrity requirements. 
  • Familiarity with CMS RADV audit standards, DMHC regulatory requirements, NCQA standards, and delegated health plan oversight requirements. 
  • Ability to identify documentation deficiencies, coding inconsistencies, compliance risks, and audit-related concerns. 
  • Strong organizational, analytical, auditing, and data tracking skills with exceptional attention to detail and accuracy. 
  • Ability to maintain accurate records, audit logs, compliance documentation, and reporting tools. 
  • Proficiency with electronic health records, Risk Adjustment platforms, coding software, and Microsoft Office applications. 
  • Strong verbal and written communication skills with the ability to communicate professionally with providers, coders, leadership, health plans, and interdisciplinary teams. 
  • Ability to handle confidential and sensitive information in compliance with HIPAA and organizational policies. 
  • Ability to manage multiple priorities, deadlines, and audit-related activities in a fast-paced managed care environment.
  • Ability to work independently while collaborating effectively within interdisciplinary operational and compliance teams.

PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS:

The physical demands described here are represented of those that must be met by an employee to successfully perform the essential functions of this job. Primarily sedentary work involving prolonged computer use. Occasional standing, walking, and local travel may be required. Ability to lift up to 20 pounds occasionally. Requires strong attention to detail, data analysis capability, and effective communication skills. Work is performed in an office or remote environment supporting electronic medical record and Risk Adjustment systems.


PAY RANGE

$30.00 - $34.00 / hourly

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