Certified Risk Coder

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

Key Responsibilities

• Review medical records and provider documentation to ensure accurate capture of risk-adjusting diagnoses and compliance with CMS guidelines
• Perform retrospective and prospective HCC coding reviews to identify documentation and coding opportunities
• Validate ICD-10-CM codes and ensure diagnoses are clinically supported and accurately reported
• Conduct coding audits and quality reviews to maintain documentation integrity and regulatory compliance
• Partner with providers and clinical teams to improve documentation accuracy and risk adjustment performance
• Deliver one-on-one and group education sessions on coding, documentation, and risk adjustment best practices
• Communicate audit findings, coding trends, and improvement opportunities to providers and leadership
• Stay current on ICD-10-CM, HCC, CMS Risk Adjustment, and payer-specific coding requirements
• Support process improvement initiatives that enhance coding accuracy, compliance, and operational efficiency
• Serve as a coding resource and mentor to team members, supporting training and knowledge sharing across the organization
• Participate in special projects, departmental initiatives, and high-volume work efforts as assigned

Skills, Knowledge & Expertise

• Certified Risk Adjustment Coder (CRC) credential
• At least two (2) years of risk adjustment, HCC coding, medical coding, or related healthcare experience
• Working knowledge of Medicare Advantage Risk Adjustment and Hierarchical Condition Categories (HCC)
• Proficiency with ICD-10-CM coding guidelines and CMS Risk Adjustment methodologies
• Experience using Electronic Health Records (EHRs), coding software, and Microsoft Office applications
• Excellent communication and presentation skills with the ability to educate providers and office staff
• Strong analytical, organizational, and problem-solving skills with exceptional attention to detail
• Ability to work independently in a remote environment while collaborating effectively with cross-functional teams

• Active AAPC or AHIMA certification required (CPC, CCS-P, CCS, or equivalent)
• Three (3)+ years of Risk Adjustment or Medicare Advantage coding experience
• Experience conducting coding audits and documentation reviews
• Experience educating providers on coding and documentation improvement initiatives
• Previous experience supporting value-based care, population health, or provider group environments
• Advanced presentation and PowerPoint skills

Benefits

• This is a Remote, US based position - Strong preference for candidates based in West or Central time zones
• The annual total compensation target pay range for this role is $56,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors