Astrana Health is seeking a highly skilled Coding & Revenue Integrity Specialist to support accurate, compliant, and optimized revenue cycle performance across Medicare, Medicare Advantage, Medicaid Managed Care, and Commercial payer lines.
This role is responsible for provider documentation audits, risk adjustment validation (HCC), coding compliance, provider education, and revenue integrity initiatives that drive organizational performance and reimbursement accuracy.
This is a primarily remote position based in Las Vegas, Nevada. Candidates must reside locally and be available to attend onsite meetings, provider education sessions, trainings, and operational activities on a quarterly basis or as needed.
Qualifications
- High school diploma or equivalent required; associate's or bachelor's degree preferred.
- 3-5 years of experience in medical coding, billing, auditing, revenue cycle management, or related healthcare operations.
- Strong knowledge of ICD-10-CM, CPT, HCPCS, modifier usage, medical terminology, and documentation standards.
- Experience supporting Medicare, Medicare Advantage, Medicaid Managed Care, and Commercial payer programs preferred.
- Knowledge of risk adjustment, HCC coding, provider documentation improvement, and compliance requirements.
- Experience conducting coding audits and providing provider education and feedback.
- Strong analytical, organizational, and problem-solving skills with exceptional attention to detail.
- Proficiency with EHR platforms and Microsoft Office Suite; experience with eClinicalWorks preferred.
- Ability to manage multiple priorities while working independently in a remote environment.
- Passion for operational excellence, compliance, and advancing value-based care initiatives.
Certifications
- Required: Certified Professional Coder (CPC) through AAPC or Certified Coding Specialist (CCS or CCS-P) through AHIMA.
- Preferred: Certified Risk Adjustment Coder (CRC), Certified Professional Medical Auditor (CPMA), Certified Professional Biller (CPB), or Certified Medical Reimbursement Specialist (CMRS).
Location
Las Vegas, Nevada, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
2 weeks ago