Risk Adjustment Coding Specialist

Trinity Health, one of the largest not-for-profit, Catholic healthcare systems nationally recognized for care and experience, seeks a full-time Risk Adjustment Coding Specialist. This position is 100% remote with some local travel possible (up to 10%) to various Trinity Health sites.

The Risk Adjustment Coding Specialist will work in a team environment reviewing clinical documentation and applying ICD-10-CM codes using HCC and M.E.A.T standards in compliance with CMS guidelines. Key responsibilities include accurate risk adjustment coding, identifying discrepancies, communicating documentation improvements, and supporting provider education for enhanced coding accuracy.

Key duties:

• Review and assign precise ICD-10-CM codes for provider diagnoses in the EHR.
• Utilize billing system queues and NLP tools to manage HCC codes before claim submission.
• Ensure compliance with federal, state, and payer regulations related to medical documentation and coding.
• Participate in continuing education and certification maintenance.
• Report documentation improvement opportunities to supervisor and assist in implementing provider improvement plans.

The role requires strong verbal and written communication skills, detail orientation, teamwork, and proficiency with common computer applications (Word, Excel, Outlook, Teams). Physical requirements include the ability to sit for extended periods and occasionally lift/push/pull up to 20 pounds.

Compensation is hourly between $24.60 and $32.80, which annualizes approximately to $51,288 - $68,384.

Trinity Health is committed to diversity, equity, inclusion, and providing compassionate, patient-centered care respecting the dignity of all individuals.

Certification Requirement:

• Certified Risk Adjustment Coder (CRC) required, or Certified Professional Coder (CPC) with CRC to be obtained within 12 months of hire.