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.
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Get Access To All JobsINTRODUCTION
Supports initiatives that will impact the Risk Adjustment programs and operations. Collaborates with internal departments and external vendors on risk adjustment projects and to meet business operational needs. Leverages industry resources to increase knowledge and improve return on investment (ROI) of risk adjustment activities. Understands risk adjustment models in emerging business areas, including but not limited to, Medicaid. Becomes a subject matter expert to support business functions, operations and systems. Manages the monthly risk adjustment meetings with key stakeholders to track the effectiveness of the various initiatives critical for clinical documentation accuracy. Works under general supervision.
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
- Employer-matched retirement saving funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
What You Will Do
- Performs data and analytical services in support of optimizing risk adjusted revenue, maintaining compliance with CMS standards and modeling financial impacts of changes in risk adjustment data and methodologies. Must have strong Risk Adjustment experience/knowledge.
- Collaborates regularly with internal departments, including but not limited to, Finance, Medicare Operations, Network Management, Provider Contracting, and Health Economics, and external vendors on risk adjustment projects. Calculates ROI for risk adjustment vendors, initiatives and projects.
- Multitasks and prioritizes various tasks to meet deadlines. Understands various areas of the business and operational processes relevant to the project’s goals.
- Leverages industry resources to increase knowledge and improve ROI of risk adjustment activities. Builds understanding of risk adjustment models in emerging business areas, including Medicaid.
- Maintains current knowledge of CMS’ Hierarchical Condition Categories (HCC) and Prescription Drug Risk Adjustment codes (RxHCCs) including risk adjustment values and formulas.
- Supports response to Risk Adjustment Data Validation (RADV) audits by preparing analytics.
- Assists in performing analyses used in the development of financial plans, re-forecasts, and other financial projections.
- Works with product managers to provide insights into the current state of operations and identify gaps and opportunities for improvement.
- Works on identifying gaps in the claims, encounter reconciliation process, and provides insights to educate providers to improve billing practices.
- Builds reports and dashboards to track risk adjustment related projects and track the effectiveness of the initiatives.
- Tracks compliance requirements and the various business areas using reports and provides evidence of compliance, as needed.
- Interacts with business teams to gather the requirements and translate technical language. Maps documents after the necessary data analysis.
- Participates in special projects and performs other duties as assigned.
Qualifications
Education:
- Bachelor's Degree in Public Health or related field with equivalent knowledge required
- PMP certification preferred
Work Experience:
- Minimum two years of increasingly responsible project management or operations management experience in a healthcare setting required
- Knowledge of Medicare Advantage required
- Familiarity with medical claims and medical terminology preferred
- Proficiency in personal computer programs including MS Excel (including formulas, sorts, filters, pivot tables, IF statements, VLOOKUP, HLOOKUP, etc.), Access (criteria statements, table links, and database and report creation), and Word required
- Experience working with MS project or other project management platform.
Effective oral, written and interpersonal communication skills required
Pay Range
USD $93,400.00 - USD $116,800.00 /Yr.
About us
VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.
INTRODUCTION
Supports initiatives that will impact the Risk Adjustment programs and operations. Collaborates with internal departments and external vendors on risk adjustment projects and to meet business operational needs. Leverages industry resources to increase knowledge and improve return on investment (ROI) of risk adjustment activities. Understands risk adjustment models in emerging business areas, including but not limited to, Medicaid. Becomes a subject matter expert to support business functions, operations and systems. Manages the monthly risk adjustment meetings with key stakeholders to track the effectiveness of the various initiatives critical for clinical documentation accuracy. Works under general supervision.
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
- Employer-matched retirement saving funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
What You Will Do
- Performs data and analytical services in support of optimizing risk adjusted revenue, maintaining compliance with CMS standards and modeling financial impacts of changes in risk adjustment data and methodologies. Must have strong Risk Adjustment experience/knowledge.
- Collaborates regularly with internal departments, including but not limited to, Finance, Medicare Operations, Network Management, Provider Contracting, and Health Economics, and external vendors on risk adjustment projects. Calculates ROI for risk adjustment vendors, initiatives and projects.
- Multitasks and prioritizes various tasks to meet deadlines. Understands various areas of the business and operational processes relevant to the project’s goals.
- Leverages industry resources to increase knowledge and improve ROI of risk adjustment activities. Builds understanding of risk adjustment models in emerging business areas, including Medicaid.
- Maintains current knowledge of CMS’ Hierarchical Condition Categories (HCC) and Prescription Drug Risk Adjustment codes (RxHCCs) including risk adjustment values and formulas.
- Supports response to Risk Adjustment Data Validation (RADV) audits by preparing analytics.
- Assists in performing analyses used in the development of financial plans, re-forecasts, and other financial projections.
- Works with product managers to provide insights into the current state of operations and identify gaps and opportunities for improvement.
- Works on identifying gaps in the claims, encounter reconciliation process, and provides insights to educate providers to improve billing practices.
- Builds reports and dashboards to track risk adjustment related projects and track the effectiveness of the initiatives.
- Tracks compliance requirements and the various business areas using reports and provides evidence of compliance, as needed.
- Interacts with business teams to gather the requirements and translate technical language. Maps documents after the necessary data analysis.
- Participates in special projects and performs other duties as assigned.
Qualifications
Education:
- Bachelor's Degree in Public Health or related field with equivalent knowledge required
- PMP certification preferred
Work Experience:
- Minimum two years of increasingly responsible project management or operations management experience in a healthcare setting required
- Knowledge of Medicare Advantage required
- Familiarity with medical claims and medical terminology preferred
- Proficiency in personal computer programs including MS Excel (including formulas, sorts, filters, pivot tables, IF statements, VLOOKUP, HLOOKUP, etc.), Access (criteria statements, table links, and database and report creation), and Word required
- Experience working with MS project or other project management platform.
Effective oral, written and interpersonal communication skills required
Pay Range
USD $93,400.00 - USD $116,800.00 /Yr.
About us
VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.
See all 783+ Risk Adjustment Coding Jobs
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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.