We are seeking a highly motivated Risk Adjustment Coding Specialist to support our Orange County market. In this role, you will conduct high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy. You will translate findings into actionable insights, create and deliver provider education, and track key performance metrics such as HCC recapture rates, AWVs, and other KPIs.
This position supports risk adjustment efforts across Medicare Advantage, Affordable Care Act (ACO), and Commercial lines of business. The role includes collaboration with physicians and practice leaders, auditing chart documentation, identifying compliance issues, and helping drive overall provider performance and program success.
This position follows a hybrid work structure with weekly work on the field and at home, and requires travel to provider offices in Los Angeles and the San Gabriel Valley.
Qualifications
- Must possess and maintain AAPC or AHIMA certification, such as CCS-P, CCS, or CPC
- At least 3 years of experience in risk adjustment coding and/or billing
- Reliable transportation and valid driver's license
- Ability to travel up to 75% of work time
- Proficiency with Microsoft Word, Excel, and Outlook
- Excellent presentation, verbal, and written communication skills
- Ability to educate and train provider office staff members
- Experience with healthcare coding software and EHR systems
Preferred
- Certified Professional Biller (CPB)
- Certified Risk Adjustment Coder (CRC)
- Knowledge of risk adjustment and HCC for Medicare Advantage
- Strong PowerPoint and public speaking skills
- Ability to work independently and collaboratively
- Experience with Monday.com
- Experience educating and presenting to provider teams face to face
Location
California, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$70,000 - $85,000
Remote work allowed
Yes
Posted
1 month ago