Medicare & ACA Risk Adjustment Specialist

Strategic Staffing Solutions, Inc.; Baton Rouge (LA); Remote; USD 65,000 - 85,000; Full time

Job summary

Strategic Staffing Solutions in Baton Rouge, LA seeks an experienced Risk Adjustment Coder with Medicare Advantage and ACA risk adjustment coding expertise. The role focuses on accurate ICD-10-CM coding, medical record reviews, documentation validation, and QA activities to support CMS compliance and revenue integrity.

This role can be performed remotely under general supervision. You will review records, identify coding gaps, collaborate with stakeholders, and ensure timely delivery of quality

Qualifications

• Minimum of 3 years of medical coding experience.
• Strong Medicare Advantage Risk Adjustment coding experience required.
• Experience with CMS-HCC coding methodologies and risk adjustment programs.
• Experience performing medical record reviews and coding validation activities.
• Ability to work independently in a remote environment while maintaining productivity and quality.

Responsibilities

• Review and accurately assign ICD-10-CM diagnosis codes for Medicare Advantage and ACA Risk Adjustment programs.
• Perform coding reviews to identify supported HCC conditions.
• Evaluate records for coding accuracy, completeness, and CMS guidelines compliance.
• Conduct quality assurance reviews and coding audits.
• Document coding results in designated systems and maintain records.
• Collaborate with partners to support risk adjustment and coding accuracy goals.
• Maintain productivity and quality while meeting deadlines.

Skills

Medicare Advantage Risk Adjustment

CMS-HCC coding methodologies

Medical record review

Risk adjustment documentation validate

ICD-10-CM coding

Attention to detail

Analytical skills

Written and verbal communication

MS Office

EMR systems

Remote work experience

Education

High School Diploma or GED

Tools

Microsoft Office

EMR systems

Job description

Strategic Staffing Solutions in Baton Rouge, LA seeks an experienced Risk Adjustment Coder with Medicare Advantage and ACA risk adjustment coding expertise. The role focuses on accurate ICD-10-CM coding, medical record reviews, documentation validation, and QA activities to support CMS compliance and revenue integrity.

This role can be performed remotely under general supervision. You will review records, identify coding gaps, collaborate with stakeholders, and ensure timely delivery of quality