Remote Risk Adjustment Coding Specialist II

Astrana Health, Inc.

Houston (TX)

Remote

USD 70,000 - 85,000

Full time

14 days+

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Job summary

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support our Houston market in a fully remote CST/EST role. You will conduct high-volume chart reviews to identify coding gaps, deliver education to providers, and track KPIs such as HCC recapture and AWVs.

Ideal candidates have strong risk adjustment experience, AAPC CPC/CRC, and a proven ability to educate provider teams. Travel up to 75% may be required; the home office is in Monterey Park, CA. Remote in the U.S.

Qualifications

Must possess and maintain AAPC certification, CPC and CRC.
At least 3 years of experience in risk adjustment coding and/or billing experience.
At least 1 year of experience with targeted provider education.
Reliable transportation/Valid Driver’s License/Must be able to travel up to 75% of work time
PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
Excellent presentation, verbal and written communication skills, and ability to collaborate
Must possess the ability to educate and train provider office staff members
Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.

Responsibilities

Review provider documentation to verify that risk adjustment requirements are met and educate providers.
Review medical records to identify, assess, monitor, and document HCC coding information.
Perform code abstraction and/or coding quality audits to ensure ICD-10-CM codes are accurately assigned.
Interact with physicians regarding coding, billing, documentation policies and procedures.
Prepare auditing analyses and provide feedback on noncompliance issues detected through auditing.
Maintain knowledge of coding regulations and CMS guidelines; stay informed about payer requirements.
Provide recommendations to management on process improvements and barrier resolution.
Train, mentor and support new employees during orientation; assist existing staff.
Provide peer guidance and support coder training as requested by manager.
May assist or lead projects and/or higher workload.
Other duties as assigned