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Seasonal Risk Adjustment Specialist Jobs (NOW HIRING)

Molina Healthcare

Auditor, Risk Adjustment (Remote)

$49K - $107K/yr

... specialist performance.. • Facilitates audits on external Molina vendor performance. Required Qualifications • At least 5 years of coding, medical record chart review, and risk adjustment data ...

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Seasonal Risk Adjustment Specialist information

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$11K

$142.3K

$190K

How much do seasonal risk adjustment specialist jobs pay per year?

As of Aug 7, 2026, the average yearly pay for seasonal risk adjustment specialist in the United States is $142,322.00, according to ZipRecruiter salary data. Most workers in this role earn between $132,500.00 and $132,500.00 per year, depending on experience, location, and employer.

What is the difference between Seasonal Risk Adjustment Specialist vs Actuarial Analyst?

AspectSeasonal Risk Adjustment SpecialistActuarial Analyst
Required CredentialsTypically requires health insurance or risk adjustment certifications, sometimes a related degreeUsually requires actuarial credentials (SOA/ASA) and mathematics/statistics background
Work EnvironmentHealthcare or insurance companies, focusing on risk adjustment processesInsurance firms, consulting, or government agencies analyzing risk and financial models
Employer & Industry UsageCommon in health plans and Medicare/Medicaid sectorsWidely used in insurance, finance, and consulting industries

The Seasonal Risk Adjustment Specialist primarily focuses on health insurance risk adjustment processes, often requiring specific certifications related to healthcare. In contrast, an Actuarial Analyst typically holds actuarial credentials and works on broader risk modeling and financial analysis. Both roles are vital in the insurance industry but differ in scope, credentials, and work environment.

More about Seasonal Risk Adjustment Specialist jobs
What cities are hiring for Seasonal Risk Adjustment Specialist jobs? Cities with the most Seasonal Risk Adjustment Specialist job openings:
What are the most commonly searched types of Risk Adjustment Specialist jobs? The most popular types of Risk Adjustment Specialist jobs are:
What states have the most Seasonal Risk Adjustment Specialist jobs? States with the most job openings for Seasonal Risk Adjustment Specialist jobs include:
What job categories do people searching Seasonal Risk Adjustment Specialist jobs look for? The top searched job categories for Seasonal Risk Adjustment Specialist jobs are:
Seasonal Risk Adjustment Specialist jobs near you
Infographic showing various Seasonal Risk Adjustment Specialist job openings in the United States as of August 2026, with employment types broken down into 94% Full Time, and 6% Part Time. Highlights an 81% In-person, 6% Hybrid, and 13% Remote job distribution, with an average salary of $142,322 per year, or $68.4 per hour.

Medical Coder - Risk Adjustment Specialist

Volunteers of America National Services

Eden Prairie, MN • On-site

$58K - $66K/yr

Full-time

This job post has expired 1 day ago. Applications are no longer accepted.

Volunteers Of America rating

6.9

Company rating: 6.9 out of 10

Based on 127 frontline employees who took The Breakroom Quiz

385th of 769 rated non-profit organizations

Job description

Join Senior CommUnity Care as a Medical Coder - Risk Adjustment Specialist and partner directly with physicians and Medical Directors to improve documentation, support CMS reporting, and strengthen value-based care for older adults in the PACE program.
Medical Coder - Risk Adjustment Specialist- Remote
Schedule: M-F 8:00 AM-5:00 PM
Salary: $58,000-$66,000 (Based on Experience)
Essentials:
Collaboration for Risk Adjustment Integrity:
  • Works closely with Medical Directors and PACE providers to uphold the integrity and accuracy of the risk adjustment reporting process.
  • Engages in continuous dialogue with healthcare professionals to ensure that coding accurately reflects participant acuity.

Medication Documentation Review and Diagnostic Coding:
  • Reviews and interprets provider documentation to extract critical information.
  • Assigns ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures from documented information in the medical record.
  • Assures the final diagnoses and procedures are valid and complete.
  • Communicates and resolves coding issues (lacking documentation, provider queries, etc.).

Liaison Role:
  • Acts as a key intermediary between PACE providers and contracted coding services.
  • Ensures timely and effective response to coding-related inquiries and issues.

Coding Compliance and Data Analysis:
  • Facilitates the audit review process, collaborating with providers to resolve individual and systemic coding issues.
  • Leads efforts to enhance coding accuracy and compliance through regular, targeted audits.
  • Performs data analysis to uncover and seize missed coding opportunities.

Report Review and Response Process:
  • Works with clinical leadership to devise and implement procedures for generating and distributing participant specific-reports.
  • Ensures these reports are reviewed by the provider during subsequent participant clinic visits, maintaining a system for tracking and ensuring accountability.

Encounter Reporting Support:
  • Applies coding expertise to support the accuracy of the encounter reporting process in applicable programs. Acts as a resource for program leadership in determining the appropriateness of coding used for encounters.

Systems and Process Improvement:
  • Assists in the continuous improvement of systems and processes to better align with the organization's strategic goals.
  • Contributes to the development of initiatives that enhance the efficiency and accuracy of coding practices.

Remote Work and Accountability:
  • Work independently in remote setting, demonstrating high level of responsibility and accountability.
  • Collaborate with cross-functional teams as needed.

Establishes and maintains a productive working relationship.
  • Maintains the stability and reputation of SCC by ensuring all activities and operations are performed in compliance with local, State, and Federal laws, regulations and contractual requirements and adheres to organizational policies.
  • Is responsible for adherence to program cultural standards including supporting through modeling, coaching, and accountability.
  • Protects privacy and maintains confidentiality of all company procedures, results and information about employees, participants and families.
  • Participates in continuing education classes and any required staff and training meetings. Maintains professional affiliations and any required certifications.

Required Qualifications:
  • Education: Associate's degree in Health Information Management or related field.
  • Current certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) and Certified Risk Coder (CRC) required.
  • Experience: Minimum of five (5) years of experience working directly with diagnostic and procedural coding required. Strong preference for substantial experience with Hierarchical Condition Categories (HCCs) and risk adjustment methodologies.

Skills and Knowledge:
  • Ability to effectively communicate orally and in writing in English.
  • Strong technical skills with proficiency in data management.
  • Strong knowledge of medical terminology, anatomy and physiology, and disease processes.
  • Familiarity with healthcare software including EHR systems, coding software, and data analysis tools.
  • Understanding of regulatory requirements including HIPAA, CMS guidelines, AHIMA code of ethics, and other regulations affecting coding and billing.
  • Proficient ability with Excel including ability to extract meaningful information from large datasets.
  • Analytical skills and ability to interpret medical records and extract pertinent information for accurate coding.
  • Strong problem-solving and critical thinking skills.
  • Strong attention to detail.
  • Effective communication skills for presenting information.
  • Creative, detailed-oriented, and organized.
  • Must have integrity, practice discretion and practice objective problem solving.
  • Skilled in establishing and maintaining effective working relationships and working collaboratively with a multidisciplinary team.

At VOANS, we celebrate sharing, encouraging and embracing diversity. Equal employment opportunities are available to all without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, parental status, sexual orientation, gender identity, gender expression, genetic information, military and veteran status, and any other characteristic protected by applicable law. We believe that blending individual strengths and unique personal differences nurtures and supports our organizations' shared commitment to our mission and creates an inclusive and diverse environment where everyone feels valued and has the opportunity to do their personal best
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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