MEDICAL CODING SPECIALIST-RISK ADJUSTMENT

OCHIN, Inc.; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

OCHIN, Inc. is a national nonprofit health care innovator with a growing remote workforce serving member clinics and hospitals. The Medical Coding Specialist - Risk Adjustment role focuses on accurate risk-adjustment coding, high-quality data abstraction, and revenue optimization.

Candidates must hold CPC/CCS/ADCA certification (in hand) and have Epic EHR experience if possible. FQHC experience is highly desirable; this is a fully remote, nationwide position with ongoing professional growth

Qualifications

• Certificate in hand at time of application (CPC, CCS, or ADCA).
• Epic EHR experience is highly preferred.
• FQHC experience is highly desired and will be prioritized.

Responsibilities

• Deliver accurate coding services for member clinics and acute care hospitals in compliance with payer rules and coding guidelines.
• Extract and interpret clinical data from medical records to support code assignment.
• Review encounters to assign diagnosis and procedure codes ensuring completeness and accuracy.
• Assist in reimbursement optimization by recommending precise codes for third-party claims.
• Communicate with providers or clinical staff to obtain necessary information as per agreements.

Education

CPC Certificate (AAPC)

CCS Certificate (AHIMA)

ADCA (CDC certificate)

Tools

Epic EHR

Job description

All Jobs > MEDICAL CODING SPECIALIST-RISK ADJUSTMENT

MEDICAL CODING SPECIALIST-RISK ADJUSTMENT
Fully Remote Remote N/A OBS

Full-time

Description

MAKE A DIFFERENCE AT OCHIN

OCHIN is a nonprofit leader in health care innovation and a trusted partner to a growing national provider network, delivering the clinical insights and tailored technologies needed to expand patient access, strengthen care teams, and improve the health of rural and medically underserved communities.

We are hiring for a number of new positions to meet increasing demand. When you choose to join OCHIN, you have the opportunity to continuously grow your skills and do meaningful work to help fulfill our vision of good health and well-being for everyone.

At OCHIN, we value the unique perspectives and experiences of every individual and work hard to maintain a culture rooted in our values.

Founded in Oregon in 2000, OCHIN employs a growing virtual workforce of more than 1,200 skilled professionals, working remotely across 49 states. We offer a generous compensation package and are committed to supporting our employees’ entire well-being by fostering a healthy work-life balance and opportunity for professional advancement. We are curious, collaborative learners who strive to live our values every day. OCHIN is excited to support our continued national expansion and the increasing demand for our innovative tools and services by welcoming new talent to our growing team.

Work Authorization

Candidates must be legally authorized to work in the United States on a permanent basis at the time of application.

This position is not eligible for employment visa sponsorship now or in the future. OCHIN does not provide sponsorship for employment-based visas or transfers of existing employment-based visas.

Position Overview

The Outpatient Coding Specialist plays a critical role in delivering accurate and high-quality healthcare coding services to OCHIN member clinics and acute care hospital organizations. This position is responsible for identifying potential high-risk coding trends, applying best practices to optimize revenue, and enhancing coding accuracy to support a streamlined and efficient revenue cycle.

The Coding Specialist proactively escalates complex or unique coding issues, collaborates with supervisors to resolve challenges, and applies newly acquired knowledge to future scenarios. Additionally, this role contributes to continuous improvement efforts by recommending process enhancements that increase operational efficiency and effectiveness.

Essential Functions

• Accurate and Compliant Coding: Deliver efficient and accurate coding services on behalf of member clients, ensuring full compliance with payer requirements, organizational policies, and all applicable coding guidelines.
• Clinical Data Abstraction: Extract and interpret relevant clinical data—including diagnoses and procedures—from patient medical records and electronic health systems to support accurate code assignment.
• Code Assignment and Validation: Review and analyze patient encounters to assign appropriate diagnosis and procedure codes, ensuring accuracy and completeness for all relevant clinical information.
• Reimbursement Optimization: Support member organizations in achieving appropriate reimbursement by reviewing and recommending accurate code assignments that are critical to third-party payer claims.
• Provider Communication and Documentation Follow-Up: Conduct research and obtain additional information from providers or clinical staff via Epic In-Basket messaging, as needed and in accordance with established agreements. Messaging, as needed and in accordance with established agreements.
• Other duties as assigned.

Requirements

• Certificate of completion from: AAPC (CPC Certificate), AHIMA (CCS Certificate) or ADCA (CDC certificate) is REQUIRED. (Certification must be in hand at the time of your application).
• Experience working with Epic EHR highly preferred.
• Experience with FQHCs highly desired. Candidates with FQHC experience will be given priority

Physical Requirements/Work Environment

• Constant interpersonal skills, teamwork, and customer service. Frequent creativity, mentoring, presentations/teaching. Occasional decision making and independent judgment or action.
• Reading, speaking, writing, and understanding English.
• While performing the duties of the job, the employee is regularly required to sit for long periods of time; stand and walk; use hands to finger, handle or feel; reach with hands and arms.
• This position requires a virtual home-office environment, working remotely and will require that employees be on camera for all virtual meetings.
• The role routinely uses standard office equipment such as computers and mobile devices.

Work Location and Travel Requirements

OCHIN is a 100% remote organization with no physical corporate office location. Employees work remotely from home and many of our positions also support our member organizations on-site for new software installations. Nationwide travel is determined based on OCHIN business needs. Please inquire during the interview process about travel requirements for this position.

Work from home requirements are:

• Ability to work independently and efficiently from a home office environment
• High Speed Internet Service
• It is a requirement that employees work in a distraction free workplace
• Travel may be required nationally based on business requirements for OCHIN
• In alignment with OCHIN’s mission and commitment to protecting our workforce and the communities we serve, OCHIN strongly encourages all workforce members,especially those whose role involves travel and in-person engagement, to remain up to date on immunizations, including but not limited to COVID-19 and influenza vaccinations.

We offer a comprehensive range of benefits. See our website for details: https://ochin.org/career

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Base Pay Overview

OCHIN uses broadened pay ranges to support equitable and market-aligned compensation practices. The final offer will be based on a variety of factors, including relevant skills, certifications, education, experience, training, responsibilities, internal equity, and market data.

Work Authorization

Candidates must be legally authorized to work in the United States on a permanent basis at the time of application.

This position is not eligible for employment visa sponsorship now or in the future. OCHIN does not provide sponsorship for employment-based visas or transfers of existing employment-based visas.