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United Healthcare Risk Adjustment Jobs (NOW HIRING)

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82K - $108K/yr

We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

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All JobsUnited Healthcare Risk Adjustment Jobs

United Healthcare Risk Adjustment information

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$38

$67

How much do united healthcare risk adjustment jobs pay per hour?

As of Jun 13, 2026, the average hourly pay for united healthcare risk adjustment in the United States is $38.68, according to ZipRecruiter salary data. Most workers in this role earn between $23.80 and $54.33 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in a United Healthcare Risk Adjustment role, and why are they important?

To thrive in a United Healthcare Risk Adjustment role, you need a strong understanding of healthcare coding (ICD-10), risk adjustment methodologies, and medical record review, often supported by certifications like CRC or CPC. Familiarity with risk adjustment software, claims processing systems, and EHR platforms is typically required. Strong analytical thinking, attention to detail, and effective communication skills help ensure accurate assessments and collaboration with providers. These skills are crucial for optimizing risk scores, ensuring regulatory compliance, and supporting organizational financial performance.

What is the difference between United Healthcare Risk Adjustment vs Medical Coder?

AspectUnited Healthcare Risk AdjustmentMedical Coder
Primary RoleAnalyzes and documents patient health data for risk scoring and reimbursementTranslates medical reports into standardized codes for billing and records
Required CertificationsRisk adjustment training, coding certifications (e.g., CPC)Medical coding certifications (e.g., CPC, CCS)
Work EnvironmentInsurance companies, healthcare providers, remote or office-basedHospitals, clinics, insurance companies, remote or office-based
Industry UsageHealth insurance, risk management, healthcare analyticsMedical billing, healthcare documentation, coding departments

While both roles involve healthcare data, United Healthcare Risk Adjustment specialists focus on analyzing patient data for risk scoring and reimbursement, requiring specialized risk adjustment knowledge. Medical Coders primarily translate clinical documentation into codes for billing. Understanding these differences helps clarify career paths and employer expectations in the healthcare industry.

What is United Healthcare Risk Adjustment?

United Healthcare Risk Adjustment is a program designed to ensure that health plans are adequately compensated for providing coverage to individuals with varying levels of health risk. The process involves collecting and analyzing data about members’ health conditions and demographic information to determine expected healthcare costs. This helps United Healthcare allocate resources appropriately and ensures compliance with government regulations such as those from Medicare Advantage and the Affordable Care Act. Accurate risk adjustment is essential for maintaining fair and sustainable health insurance markets.

How does a United Healthcare Risk Adjustment professional typically collaborate with clinical and data analytics teams to ensure accurate documentation and reporting?

In a United Healthcare Risk Adjustment role, professionals work closely with both clinical staff and data analytics teams to ensure that patient health conditions are accurately documented and coded. This collaboration often involves reviewing medical records, providing feedback to providers on documentation best practices, and working with analysts to identify coding gaps or trends. Regular meetings and cross-functional projects are common, as accurate risk adjustment impacts reimbursement and compliance. Effective communication and teamwork are essential for addressing challenges and maintaining high data quality.
Infographic showing various United Healthcare Risk Adjustment job openings in the United States as of June 2026, with employment types broken down into 97% Full Time, 1% Part Time, 1% Temporary, and 1% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $80,460 per year, or $38.7 per hour.
HEALTH CODER - HCC & RISK ADJUSTMENT

HEALTH CODER - HCC & RISK ADJUSTMENT

North East Medical Services

Burlingame, CA • On-site

$42.79 - $48.75/hr

Other

Posted 28 days ago

Job description

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance.
ESSENTIAL JOB FUNCTIONS:
  • HCC Coding and Risk Adjustment (RA) Program Support
    • Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines.
    • Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance.
    • Conduct prospective and retrospective chart audits to assess risk adjustment coding accuracy.
  • Provider Training and Clinical Documentation Improvement (CDI)
  • Develop and deliver provider education sessions and materials on best practices for clinical documentation and HCC/RA coding.
  • Provide one-on-one and group training to providers and clinical staff to improve documentation quality and accuracy.
  • Serve as a resource and subject matter expert on HCC, risk adjustment, and related coding standards.
  • Data Analysis and Reporting
    • Analyze coding data to identify trends, documentation gaps, and opportunities for improvement.
    • Generate reports and dashboards to track coding performance and documentation accuracy.
    • Collaborate with the Quality and Analytics teams to optimize risk adjustment processes.
  • Compliance and Continuous Improvement
    • Stay up to date with changes in coding, risk adjustment, and Medicare regulations.
    • Assist in the development and implementation of internal coding policies and procedures.
    • Participate in quality improvement initiatives related to coding and documentation.
    • Performs other job duties as required by manager/supervisor

  • Education & Certification:
    • BS/BA Degree in Health Science or General Education is required.
    • Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification is required.
    • Additional CDI or auditing certifications (CCDS, CDEO, CPMA) are preferred.
  • Experience:
    • Minimum of 3 years of experience in medical coding with a focus on HCC, risk adjustment, and Medicare Advantage programs.
    • Experience in provider education, clinical documentation improvement (CDI), and chart audits.
    • Previous experience working in an IPA, managed care organization, or similar setting is strongly preferred.
  • Skills & Competencies:
    • Excellent communication, presentation, and interpersonal skills.
    • Strong understanding of CMS guidelines for Medicare Advantage and risk adjustment program.
    • Exceptional knowledge of ICD-10-CM coding and HCC risk adjustment coding methodologies.
    • Proficiency in electronic health records (EHR) and coding software.
    • Strong analytical and problem-solving skills.

LANGUAGE:
  • Must be able to fluently speak, read and write English.
  • Fluency in other languages is an asset.

STATUS:
  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This a full-time position.

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