Remote Risk Adjustment Coding Specialist II

Astrana Health, Inc.; Houston (TX); Remote; USD 70,000 - 85,000; Full time

Job summary

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support our Houston market. This remote role focuses on high-volume chart reviews, identifying coding gaps, and delivering education to providers and practice leaders.

You will track KPIs like HCC recapture rates and AWVs to drive program success. Ideal candidates live in CST or EST time zones, have strong risk adjustment experience, and can engage effectively with physicians regarding coding and documentation policies.

Qualifications

• Must have AAPC CPC certification and maintain it.
• Minimum 3 years of risk adjustment coding or billing experience.
• At least 1 year of targeted provider education experience.
• Willingness to travel up to 75% of work time and dependable transportation.

Responsibilities

• Review provider documentation to verify Medicare Advantage, ACA and Commercial risk adjustment requirements and educate providers.
• Review medical records for HCC coding accuracy and CMS risk adjustment compliance.
• Perform coding quality audits and provide feedback on noncompliance issues.
• Interact with physicians on coding, billing and documentation policies.
• Maintain knowledge of ICD-10/HCC updates and payer requirements.
• Provide training and mentorship to new staff and peers.

Skills

Risk adjustment coding

Provider education

Public speaking

MS Office

Education

AAPC CPC Certification

CRC certification preferred

Tools

EHR systems

Monday.com

PowerPoint

MS Office suite

Job description

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support our Houston market. This remote role focuses on high-volume chart reviews, identifying coding gaps, and delivering education to providers and practice leaders.

You will track KPIs like HCC recapture rates and AWVs to drive program success. Ideal candidates live in CST or EST time zones, have strong risk adjustment experience, and can engage effectively with physicians regarding coding and documentation policies.