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Seasonal Optum Health Coding Risk Adjustment Jobs

Mercor

HCC Coding Leader - Risk Adjustment

New York, NY · Remote

$110/hr

Background in health plan, Medicare Advantage organisation , or value-based care setting. * Familiarity with AI-assisted HCC coding tools and comfort evaluating AI-generated risk adjustment content

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

As of Aug 29, 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 is a Seasonal Optum Health Coding Risk Adjustment?

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.

What are the key skills and qualifications needed to thrive as a Seasonal Optum Health Coding Risk Adjustment?

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 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.

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The most popular types of Optum Health Coding Risk Adjustment jobs are:

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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 August 2026, with employment types broken down into 67% Full Time, and 33% Contract. Highlights an 67% In-person, and 33% Remote job distribution, with an average salary of $60,920 per year, or $29.3 per hour.

Risk Adjustment Coding Specialist II

Astrana Health, Inc.

Monterey Park, CA • Hybrid

$75K - $85K/yr

Full-time

Posted 18 days ago

Job description

Description
We are currently seeking a highly motivated Risk Adjustment Coding Specialist. This role will report to the Supervisor - Risk Adjustment and enable us to continue to scale in the healthcare industry. The staff is required to frequently travel to provider sites depending on projects.
Our Values: 
  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence
  • Be Innovative
  • Work As One Team

What You'll Do
  • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company 
  • Review medical record information on both a retrospective and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC) 
  • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines 
  • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation 
  • Meets or exceeds productivity targets as established by management. Regularly meets due dates assigned 
  • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing 
  • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements. 
  • Keeps management apprised of project activities through regular written and oral status reports. Proactively identifies risks that may hinder project success. 
  • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives. 
  • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work. 
  • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager. 
  • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I 

Qualifications
  • Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification – Certified Coding Specialist (CCS) and/or Certified Professional Coder (CPC). Certified Risk Adjustment Coder (CRC) is a plus but not required
  • 3+ years experience in risk adjustment coding required. Billing experience is a plus. 
  • Reliable transportation/Valid Driver’s License/Must be able to travel at least 75% of work time 
  • PC skills and experience using Microsoft applications such as Word, Excel, and PowerPoint
  • Excellent presentation, verbal and written communication skills, and ability to collaborate
  • Must possess the ability to educate and train provider office staff members 
  • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems. 
You’re great for the role if: 
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage 
  • Ability to work independently and collaborate in a team setting 
  • Strong organizational and time-management skills 
  • Ability to work in a home office for continuous periods of time for business continuity 
  • Ability to travel across the Provider Clinic service region for meetings and/or training as needed 
  • Able to work independently and within time constraints
  • Able to efficiently prioritize multiple high-priority tasks

Environmental Job Requirements and Working Conditions
  • This position blends on-site fieldwork (approximately 75% travel) with hybrid support to help practices. The Company reserves the right to modify the work arrangement, including transitioning to a hybrid or onsite model, based on business needs. Disclaimer: This job description is intended to describe the general nature and level of work performed. It is not intended to be an exhaustive list of all responsibilities, duties, or qualifications required. Responsibilities may change based on business needs and organizational priorities.
  • The national target pay range for this role is $75,000 - $85,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. 
 
Additional Information: 
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.