Remote Risk Adjustment Coder — Educate & Improve Quality

Astrana Health, Inc.; United States; On-site; USD 56,000 - 85,000; Full time

Job summary

Astrana Health, Inc. is seeking a Certified Risk Coder to support value-based care and risk adjustment initiatives from a remote US-based position. You will review records, code to CMS guidelines, and educate providers to improve documentation and risk capture.

The role requires a CRC credential, 2+ years in risk adjustment, strong ICD-10-CM knowledge, and experience with EHRs. Collaboration with clinical teams and ongoing process improvements are essential to success.

Qualifications

• Certified Risk Adjustment Coder (CRC) credential required.
• At least two (2) years of risk adjustment, HCC coding, medical coding, or related healthcare experience.
• Working knowledge of Medicare Advantage Risk Adjustment and Hierarchical Condition Categories (HCC).
• Proficiency with ICD-10-CM coding guidelines and CMS Risk Adjustment methodologies.
• Experience using Electronic Health Records (EHRs), coding software, and Microsoft Office applications.
• Excellent communication and presentation skills with the ability to educate providers and office staff.

Responsibilities

• Review medical records and provider documentation to ensure accurate capture of risk-adjusting diagnoses and CMS compliance.
• Perform retrospective and prospective HCC coding reviews to identify documentation opportunities.
• Validate ICD-10-CM codes and ensure diagnoses are clinically supported and accurately reported.
• Conduct coding audits and quality reviews to maintain documentation integrity and regulatory compliance.
• Partner with providers and clinical teams to improve documentation accuracy and risk adjustment performance.
• Deliver individual and group education sessions on coding and risk adjustment best practices.
• Communicate audit findings, coding trends, and improvement opportunities to providers and leadership.
• Stay current on ICD-10-CM, HCC, CMS Risk Adjustment, and payer-specific coding requirements.
• Support process improvement initiatives that enhance coding accuracy and efficiency.
• Serve as a coding resource and mentor to team members across the organization.
• Participate in special projects and department initiatives.

Skills

Risk adjustment

HCC coding

CMS guidelines

EHR proficiency

Communication

Analytical thinking

Education

CRC credential

AAPC/AHIMA certification

Tools

EHR systems

Microsoft Office

Coding software

Job description

Astrana Health, Inc. is seeking a Certified Risk Coder to support value-based care and risk adjustment initiatives from a remote US-based position. You will review records, code to CMS guidelines, and educate providers to improve documentation and risk capture.

The role requires a CRC credential, 2+ years in risk adjustment, strong ICD-10-CM knowledge, and experience with EHRs. Collaboration with clinical teams and ongoing process improvements are essential to success.