Risk Adjustment Coding Jobs in USA with Visa Sponsorship
Risk adjustment coding roles attract strong H-1B visa and green card sponsorship from health plans, managed care organizations, and risk-bearing provider groups. Employers routinely sponsor CRC-credentialed coders, with specialty occupation status supported by healthcare administration or health information management degrees. For detailed occupation requirements, see the O*NET profile.
Find Risk Adjustment Coding JobsOverview
Showing 5 of 669+ Risk Adjustment Coding jobs
See all 669+ Risk Adjustment Coding Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Risk Adjustment Coding roles.
Get Access To All JobsDescription
We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Northern California market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You’ll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you’ll track and report on key performance metrics—such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success.
We are seeking candidates who have experience with risk adjustment experience, and we are open to training those without previous provider education experience! This position requires travel to provider offices up to 50% of the time in San Francisco, San Mateo, and Santa Clara.
Our Values:
* Put Patients First
* Empower Entrepreneurial Provider and Care Teams
* Operate with Integrity & Excellence
* Be Innovative
* Work As One Team
- 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 retroactive 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
- 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
- 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
- Other duties as assigned
Qualifications
- Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification - Certified Coding Specialist (CCS-P), CCS, or CPC
- At least 3 years of experience in risk adjustment coding and/or billing experience required
- Reliable transportation/Valid Driver’s License/Must be able to travel up to 75% of work time
- PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
- 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 this role if:
- Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC
- Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience
- Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
- Strong PowerPoint and public speaking experience
- Ability to work independently and collaborate in a team setting
- Experience with Monday.com
- Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting
Environmental Job Requirements and Working Conditions
- The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors
- This role follows a hybrid work structure where the expectation is to work on the field and at home on a weekly basis. This position requires up to 50% travel to provider offices in San Francisco, San Mateo, and Santa Clara. There can be weeks that are fully remote, and then weeks where there are more in-office provider needs!
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.
About Astrana Health, Inc.
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.
Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Description
We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Northern California market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You’ll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you’ll track and report on key performance metrics—such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success.
We are seeking candidates who have experience with risk adjustment experience, and we are open to training those without previous provider education experience! This position requires travel to provider offices up to 50% of the time in San Francisco, San Mateo, and Santa Clara.
Our Values:
* Put Patients First
* Empower Entrepreneurial Provider and Care Teams
* Operate with Integrity & Excellence
* Be Innovative
* Work As One Team
- 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 retroactive 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
- 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
- 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
- Other duties as assigned
Qualifications
- Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification - Certified Coding Specialist (CCS-P), CCS, or CPC
- At least 3 years of experience in risk adjustment coding and/or billing experience required
- Reliable transportation/Valid Driver’s License/Must be able to travel up to 75% of work time
- PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
- 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 this role if:
- Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC
- Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience
- Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
- Strong PowerPoint and public speaking experience
- Ability to work independently and collaborate in a team setting
- Experience with Monday.com
- Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting
Environmental Job Requirements and Working Conditions
- The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors
- This role follows a hybrid work structure where the expectation is to work on the field and at home on a weekly basis. This position requires up to 50% travel to provider offices in San Francisco, San Mateo, and Santa Clara. There can be weeks that are fully remote, and then weeks where there are more in-office provider needs!
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.
About Astrana Health, Inc.
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.
Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
See all 669+ Risk Adjustment Coding Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Risk Adjustment Coding roles.
Get Access To All JobsTips for Finding Risk Adjustment Coding Jobs
Target managed care and health plan employers
Large health plans and Medicare Advantage organizations file the most LCAs for risk adjustment coding roles. These employers have established immigration programs and legal infrastructure, making sponsorship significantly more straightforward than smaller outpatient clinics or independent practices.
Earn your CRC or CCS credential before applying
The Certified Risk Adjustment Coder credential from AAPC signals specialty-level expertise to both employers and USCIS. Credentialed candidates face far less resistance on specialty occupation determinations because the credential reinforces that the role requires specialized knowledge beyond general coding.
Frame your degree against the specialty occupation standard
USCIS scrutinizes whether risk adjustment coding genuinely requires a bachelor's degree. Degrees in health information management, healthcare administration, or biology strengthen your petition considerably. Pair your degree with CRC certification to build the most defensible specialty occupation argument.
Ask about cap-exempt or cap-subject H-1B filing early
If your prospective employer is a nonprofit hospital system or university-affiliated health plan, you may qualify for cap-exempt H-1B filing year-round. Confirm the employer's cap status before the April lottery window closes so you're not waiting an additional year.
Negotiate an employment start date that accounts for processing
Standard H-1B processing runs three to five months. If you're changing employers or entering from outside the U.S., build that buffer into your offer negotiation. Premium processing reduces the adjudication window to roughly two weeks and is worth requesting for time-sensitive starts.
Document remote work arrangements explicitly in your petition
Risk adjustment coding is commonly performed remotely, but USCIS requires Labor Condition Applications to list all worksite locations. If you'll work from home, your employer must file an LCA covering your home address state to keep your petition in compliance.
Frequently Asked Questions
Is risk adjustment coding considered a specialty occupation for H-1B purposes?
It can qualify, but USCIS evaluates these petitions closely. The strongest cases pair a bachelor's degree in health information management, healthcare administration, or a clinical field with a CRC or CCS credential and a job description emphasizing complex ICD-10-CM hierarchical condition category analysis. Generic coding roles with broad degree requirements have faced RFEs, so specificity in the job description matters considerably.
Which employers are most likely to sponsor risk adjustment coders?
Medicare Advantage health plans, Medicaid managed care organizations, and large risk-bearing provider groups file the most LCAs for these roles. Companies running retrospective and prospective chart review programs at scale, including those serving CMS-contracted plans, tend to have active immigration programs. Browse open sponsorship roles on Migrate Mate to see which employers are currently hiring internationally.
Does a CRC certification substitute for a bachelor's degree in an H-1B petition?
No. USCIS requires a U.S. bachelor's degree or its equivalent in a specific specialty for H-1B visa classification. The CRC credential strengthens the specialty occupation argument but does not replace the degree requirement. If your degree is from outside the U.S., a credential evaluation from a NACES-member organization confirming equivalency to a U.S. bachelor's is required.
Can risk adjustment coders work remotely on an H-1B visa?
Yes, but the H-1B petition must reflect every location where work is performed. Your employer needs to file a Labor Condition Application listing your home address worksite, and you must have a copy of the LCA available at that location. Moving to a new state without updating the LCA and potentially amending the H-1B petition creates compliance risk for both you and your employer.
How long does green card sponsorship typically take for risk adjustment coding roles?
Most risk adjustment coders qualify under EB-3, which requires PERM labor certification before the I-140 immigrant visa petition. PERM itself takes roughly 18 to 24 months under current DOL processing times. For applicants born in India or China, priority date backlogs can extend total wait times considerably beyond that. EB-2 NIW is generally not applicable unless the role involves significant research or policy contributions.
What is the prevailing wage requirement for sponsored Risk Adjustment Coding jobs?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.