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Work From Home Medicare Risk Adjustment Jobs (NOW HIRING)

Vertek Staffing

HCC Risk Adjustment Coder

Franklin, TN · Remote

$18 - $24/hr

HCC / Risk Adjustment Coder - Remote Risk Adjustment / HCC Coding Experience Required Required ... Experience with Medicare Advantage populations * Experience with value-based care programs

HealthEdge

Director, Risk Adjustment Products

The Director will work closely with technical and operations teams, both internally and externally ... Partner with Legal, Compliance, and Policy teams to interpret and operationalize updates from CMS ...

Urrly

Telehealth Nurse Practitioner

Huntsville, AL · Remote

$600 - $720/day

Work from home and earn $600-$720 per day delivering telehealth visits on your schedule. (Must be ... Familiar with HEDIS and risk adjustment workflows * Medicare and Medicaid provider enrollment ...

US Tech Solutions

Medical Billing Coder

Wellesley, MA · Remote

$20.50 - $27.50/hr

... support of the Medicare risk adjustment retrospective initiative and Risk Adjustment Data ... Prepare reports of the data gathered and received from Client's providers/members, ensuring reports ...

Urrly

Telehealth Nurse Practitioner

$600 - $720/day

Telehealth Nurse Practitioner Work from home and earn $600-$720 per day delivering telehealth ... Familiar with HEDIS and risk adjustment workflows * Medicare and Medicaid provider enrollment ...

Urrly

Telehealth Nurse Practitioners

Los Angeles, CA · Remote

$600 - $720/day

Work from home and earn $600-$720 per day delivering telehealth visits on your schedule. Active ... Familiar with HEDIS and risk adjustment workflows * Medicare and Medicaid provider enrollment ...

Urrly

Telehealth Nurse Practitioner

Indianapolis, IN · Remote

$600 - $720/day

Work from home and earn $600-$720 per day delivering telehealth visits on your schedule. Active ... Familiar with HEDIS and risk adjustment workflows * Medicare and Medicaid provider enrollment ...

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All JobsMedicare Risk Adjustment JobsWork From Home Medicare Risk Adjustment Jobs

Work From Home Medicare Risk Adjustment information

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$12

$22

$40

How much do work from home medicare risk adjustment jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for work from home medicare risk adjustment in the United States is $22.42, according to ZipRecruiter salary data. Most workers in this role earn between $16.11 and $27.16 per hour, depending on experience, location, and employer.

What is the difference between Work From Home Medicare Risk Adjustment vs Work From Home Medicare Coding Specialist?

AspectWork From Home Medicare Risk AdjustmentWork From Home Medicare Coding Specialist
Required CredentialsCertifications in risk adjustment, healthcare complianceMedical coding certifications (CPC, CCS)
Work EnvironmentRemote, collaborative with healthcare teamsRemote, focused on coding documentation
Employer & Industry UsageHealth plans, Medicare Advantage organizationsHospitals, billing companies, healthcare providers
Common Search & ComparisonYesNo

Work From Home Medicare Risk Adjustment involves analyzing patient data to predict healthcare costs and ensure accurate reimbursements, requiring risk adjustment certifications. In contrast, Work From Home Medicare Coding Specialists focus on reviewing medical records and assigning appropriate codes, primarily needing coding certifications. Both roles are remote and essential in the healthcare industry but serve different functions within Medicare services.

What are the key skills and qualifications needed to thrive as a work from home Medicare risk adjustment specialist?

To excel as a Work From Home Medicare Risk Adjustment Specialist, you need a deep understanding of ICD-10 coding, risk adjustment methodologies, and relevant healthcare regulations, often supported by a coding certification such as CPC, CRC, or CCS. Familiarity with electronic health record (EHR) systems, coding software, and secure remote communication platforms is crucial. Strong attention to detail, self-motivation, and effective written communication help you accurately review and document patient data while working independently. These skills ensure accurate risk score calculations, regulatory compliance, and effective collaboration with healthcare teams from a remote setting.

What are some common challenges faced when working from home in a Medicare risk adjustment role, and how can they be addressed?

One of the main challenges in a work-from-home Medicare Risk Adjustment role is maintaining effective communication with team members and providers, as much of the collaboration is virtual. Staying updated on frequently changing CMS guidelines and documentation requirements can also be demanding. To address these challenges, it's important to establish regular check-ins with your team, utilize secure digital platforms for information sharing, and dedicate time each week to review new regulations. Staying organized and building strong virtual relationships with colleagues can help ensure accuracy and efficiency in risk adjustment processes.

What is a work from home Medicare risk adjustment job?

Work From Home Medicare Risk Adjustment jobs involve evaluating and documenting patient health records to ensure accurate risk scoring for Medicare Advantage plans. Professionals in these roles typically review medical charts, identify diagnoses, and ensure documentation meets regulatory requirements, all from a remote setting. These positions help healthcare organizations receive proper reimbursement from Medicare by accurately reflecting the health status of enrollees. Strong attention to detail, knowledge of ICD-10 coding, and experience with healthcare regulations are usually required.
More about Work From Home Medicare Risk Adjustment jobs
What cities are hiring for Work From Home Medicare Risk Adjustment jobs? Cities with the most Work From Home Medicare Risk Adjustment job openings:
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Work From Home Medicare Risk Adjustment jobs near you
Infographic showing various Work From Home Medicare Risk Adjustment job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $46,633 per year, or $22.4 per hour.

Licensed Call Center work from home medicare sales professionals

The Medicare Academy

Houston, TX • Remote

$12 - $22/hr

Temporary

Posted 15 days ago

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Job description

We are seeking self starting motivated work from home call center licensed professional agents to join our small, focused team of 1099 agents. Ideal candidates will have experience in Medicare Advantage sales and must  a be licensed health insurance agents, released from previous agencies. This role involves handling very warm inbound calls independently (no outbound cold calls) using company-provided software, with no travel requirements and periodic check-ins to support your work. Bilingual candidates are preferred to better serve our diverse client base. This unique role allows you to set your hours and schedule, allows you to design your hourly + commission schedule and includes bonuses payable for top producers. Potential for post AEP opportunities as you obtain additional experience/ . Agent that onboard now are to the front of the line with opportunities. 

Responsibilities

  • Handle inbound very warm calls as a licensed health insurance agent
  • Complete 2027 Medicare Advantage certifications
  • Conduct Medicare Advantage sales
  • Work independently with periodic team check-ins
  • Utilize company-provided software tools efficiently
  • Maintain compliance as a released agent from past agencies and be able to obtain appointments from all carriers in the markets being served
  • Communicate effectively with clients, preferably in multiple languages

Preferred / Required Qualifications

  • Licensed Health Insurance Agent
  • Released from all prior carriers appointment
  • Must be able to add additional a few states for non-resident licenses
  • Completion of 2027 Medicare certifications
  • Have E&O insurance
  • Preferred Medicare sales experience
  • Strong communication skills
  • Problem-solving abilities
  • Effective time management

Company Description

If you are looking for lead support and an uncapped earning potential during this AEP we should talk. We have partnered with a leading marketing agency to ensure that your phone will ring. Time is running out.