Remote Certified Risk Adjustment Specialist

Hatchproof; United States; Remote; USD 56,000 - 85,000; Full time

Job summary

Astrana Health is seeking a Certified Risk Coder to support value-based care by ensuring accurate capture and validation of diagnoses through detailed medical record reviews and coding analysis. The role partners with providers to improve documentation and CMS risk-adjustment compliance.

The ideal candidate has CRC credentials, 2+ years in risk adjustment, and strong communication skills to educate providers and drive performance improvements in a remote US-based environment.

Qualifications

• CRC credential required (AAPC/AHIMA).
• 2+ years in risk adjustment, HCC coding, or related healthcare experience.
• Working knowledge of Medicare Advantage Risk Adjustment and HCCs.
• Proficiency with ICD-10-CM guidelines and CMS risk methods.
• Experience with EHRs, coding software, and MS Office.
• Strong communication and presentation skills for provider education.

Responsibilities

• Review medical records to ensure accurate risk-adjusting diagnoses.
• Perform retrospective and prospective HCC coding reviews.
• Validate ICD-10-CM codes with clinical support and CMS guidelines.
• Audit coding for documentation integrity and compliance.
• Collaborate with providers to improve documentation and risk performance.
• Deliver individual and group education on coding and risk adjustment.
• Report audit findings and trends to providers and leadership.
• Stay current on ICD-10-CM, HCCs, and payer requirements.
• Support process improvements to enhance accuracy and efficiency.
• Serve as coding resource and mentor to teammates.

Skills

Risk adjustment coding

Medical documentation education

Communication skills

Attention to detail

Remote work capability

Education

CRC certification (AAPC/AHIMA)

Tools

EHRs

Coding software

Microsoft Office

Job description

Astrana Health is seeking a Certified Risk Coder to support value-based care by ensuring accurate capture and validation of diagnoses through detailed medical record reviews and coding analysis. The role partners with providers to improve documentation and CMS risk-adjustment compliance.

The ideal candidate has CRC credentials, 2+ years in risk adjustment, and strong communication skills to educate providers and drive performance improvements in a remote US-based environment.