Remote Coding & Revenue Integrity Specialist

Astrana Health, Inc.; Las Vegas (NV); À distance; USD 34 000 - 43 000; Plein temps

Résumé du poste

Astrana Health is seeking a Coding & Revenue Integrity Specialist to ensure accurate coding and compliant revenue cycle across payer lines. You will perform provider documentation audits, validate HCCs, and educate providers on coding standards.

Based in Las Vegas area, this remote role requires onsite quarterly meetings and a local residence to attend sessions. You will collaborate with Revenue Cycle, Quality, and Clinical Operations to improve workflows and reimbursement accuracy.

Qualifications

• 3–5 years of experience in medical coding, billing, auditing or related healthcare operations.
• Strong knowledge of ICD-10-CM, CPT, HCPCS, modifier usage and documentation standards.

Responsabilités

• Conduct prospective and retrospective chart audits to ensure coding accuracy, documentation integrity, and regulatory compliance.
• Accurately assign ICD-10-CM, CPT, HCPCS, and modifier codes based on provider documentation and coding guidelines.
• Validate HCC and Risk Adjustment diagnoses and identify documentation opportunities that support accurate risk capture.
• Identify coding, documentation, and compliance gaps and provide actionable feedback to providers and operational teams.
• Perform routine coding audits, track findings and trends, and support corrective action initiatives.
• Deliver provider and staff education on documentation standards, coding requirements, compliance guidelines, and risk adjustment best practices.
• Support clean claim submission, denial prevention efforts, revenue optimization, and resolution of coding-related billing issues.
• Collaborate with Revenue Cycle, Quality, Clinical Operations, and provider teams to improve workflows and revenue integrity outcomes.
• Assist with audit readiness activities and maintain compliance with CMS, payer, HIPAA, and organizational requirements.
• Contribute to process improvement initiatives that strengthen coding quality, reimbursement accuracy, and overall revenue cycle performance.

Connaissances

Medical coding

Auditing

HCC coding

Risk adjustment

Regulatory compliance

Provider education

EHR proficiency

Analytical skills

Remote work

Formation

Associate's or Bachelor's degree preferred

Outils

EHR platforms (general)

Microsoft Office Suite

eClinicalWorks

Description du poste

Astrana Health is seeking a Coding & Revenue Integrity Specialist to ensure accurate coding and compliant revenue cycle across payer lines. You will perform provider documentation audits, validate HCCs, and educate providers on coding standards.

Based in Las Vegas area, this remote role requires onsite quarterly meetings and a local residence to attend sessions. You will collaborate with Revenue Cycle, Quality, and Clinical Operations to improve workflows and reimbursement accuracy.