Remote Risk Adjustment Coding Specialist

Astrana Health Management; Monterey Park, Northern (CA, KY); Hybrid; USD 56,000 - 85,000; Full time

Job summary

Astrana Health Management is seeking a Certified Risk Coder for a remote, US-based role to support value-based care and CMS risk adjustment initiatives. The successful candidate will review records, validate ICD-10-CM codes, and perform HCC coding analyses to improve documentation quality and compliance.

The ideal candidate holds a CRC credential, has 2+ years of risk adjustment experience, and excels in communication and educating providers.

Qualifications

• CRC credential required.
• 2+ years of risk adjustment or related coding experience.
• Experience with Medicare Advantage coding and HCC.
• Proficiency in ICD-10-CM coding guidelines and CMS risk adjustment methods.

Responsibilities

• Review medical records to capture risk-adjusting diagnoses and ensure CMS guidelines compliance.
• Perform retrospective and prospective HCC coding reviews to identify opportunities for improvement.
• Validate ICD-10-CM codes and ensure clinical support for diagnoses.
• Conduct coding audits and quality reviews to maintain documentation integrity.
• Educate providers and staff on coding and documentation best practices.
• Communicate audit findings and trends to providers and leadership.
• Stay current on ICD-10-CM, HCC, and payer-specific coding requirements.
• Support process improvements to enhance accuracy and efficiency.
• Mentor team members and participate in special projects.

Skills

CRC credential

Communication

Presentation

Remote work capability

Tools

EHRs

Coding software

Microsoft Office

Job description

Astrana Health Management is seeking a Certified Risk Coder for a remote, US-based role to support value-based care and CMS risk adjustment initiatives. The successful candidate will review records, validate ICD-10-CM codes, and perform HCC coding analyses to improve documentation quality and compliance.

The ideal candidate holds a CRC credential, has 2+ years of risk adjustment experience, and excels in communication and educating providers.