Risk Adjustment Coding Specialist supporting risk adjustment efforts through chart reviews and provider education. Estimated travel up to 75% in Inland Empire region, specifically LA or Orange County.
About the role
- Certified Risk Adjustment Coder ensuring accurate coding of medical procedures and diagnoses in a hybrid healthcare environment. Collaborating closely with providers to maintain high standards of documentation.
Responsibilities
- Review and analyze patient medical records to assign appropriate ICD-10, CPT, and HCPCS codes
- Ensure coding accuracy and compliance with federal regulations, payer policies, and internal standards
- Collaborate with healthcare providers to clarify documentation and resolve coding discrepancies
- Submit coded data to billing systems to initiate insurance claims and support reimbursement
- Maintain and update patient data for long-term tracking and reporting
- Participate in audits and quality reviews to ensure coding integrity
- Stay current with changes in medical coding guidelines, CMS updates, and payer requirements
- Support internal compliance and contribute to external audit readiness
Requirements
- Certified Risk Adjustment Coder (CRC) Certification
- Minimum 2–3 years of experience in medical risk adjustment coding
- Familiarity with value-based care and risk-bearing contracts
- Strong understanding of medical terminology, anatomy, and disease classification systems
- Proficiency with Electronic Health Records (EHR) and coding software
- Working knowledge of Microsoft Office
- Excellent attention to detail and analytical skills
- Ability to work collaboratively in a fast-paced clinical environment
Benefits
- Professional development opportunities
- Hybrid work arrangement
- Employee engagement activities
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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