Remote Risk Adjustment Coding Oversight Specialist

Talentify; Houston (TX); Remote; USD 40,000 - 57,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Disability insurance

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Time Off / PTO

Job summary

Aston Carter is seeking a Risk Adjustment Coding Oversight Specialist to lead retrospective chart reviews and QA across Medicare Advantage risk adjustment programs. You will oversee audits of internal and external coders, ensure compliance, and report QA findings to leadership.

The role emphasizes collaboration with vendor contacts and internal teams in a remote, high-volume environment. Ideal candidates bring CPC/CCS and CRC credentials, 2+ years in medical record review or risk coding, and

Qualifications

• Current CPC or AHIMA CCS credential is required.
• Current CRC certification is required.
• 2+ years in medical record review, risk adjustment, or quality auditing.
• 2–3 years hands-on risk adjustment coding experience.

Responsibilities

• Conduct quality oversight audits of risk adjustment coding for internal and external coders.
• Perform retrospective chart reviews to validate diagnosis coding.
• Identify and adjust diagnoses based on chart reviews to ensure accurate capture of conditions.
• Document QA findings and trends for leadership.
• Ensure vendor SLAs and quality standards are met.
• Collaborate with vendors and internal teams to resolve coding issues.

Skills

CPC

AHIMA CCS

CRC

Medical record review

Risk adjustment coding

AI coding tools

Independent worker

Attention to detail

Communication

High school diploma

Education

Associate’s degree

High school diploma or equivalent

Tools

AI coding tools

Coding platforms

Job description

Aston Carter is seeking a Risk Adjustment Coding Oversight Specialist to lead retrospective chart reviews and QA across Medicare Advantage risk adjustment programs. You will oversee audits of internal and external coders, ensure compliance, and report QA findings to leadership.

The role emphasizes collaboration with vendor contacts and internal teams in a remote, high-volume environment. Ideal candidates bring CPC/CCS and CRC credentials, 2+ years in medical record review or risk coding, and