Remote Risk Adjustment Coding Specialist II — Educator

Astrana Health, Inc.; Monterey Park, Northern (CA, KY); Hybrid; 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 while working remotely in CST/EST time zones.

You will review chart data to ensure Medicare Advantage and other risk-adjustment documentation meets CMS requirements and provide education to providers. You’ll perform code abstractions, audits, and metrics tracking, mentor new staff, and stay current with ICD-10 and HCC updates.

Qualifications

• Must possess and maintain AAPC CPC and CRC certifications.
• Minimum 3 years of risk adjustment coding and/or billing experience.
• At least 1 year of targeted provider education experience.
• Reliable transportation and ability to travel up to 75% of work time.
• Proficient with Microsoft Word, Excel, Outlook.
• Excellent written and verbal communication; able to educate staff.

Responsibilities

• Review diagnostic data to ensure Medicare Advantage/ACO/Commercial risk documentation is complete and educate providers.
• Audit and review medical records to document HCC and coding accuracy.
• Educate and train physicians and staff on coding, policies, and CMS guidelines.
• Mentor new employees and support coder training.
• Identify process improvements and report auditing findings.
• Stay current on ICD-10, HCC, and payer requirements.
• Coordinate with providers to resolve documentation gaps.

Skills

Risk adjustment coding

Provider education

CMS guidelines

Microsoft Office

Communication skills

Public speaking

EHR systems

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Monday.com

Job description

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support our Houston market while working remotely in CST/EST time zones.

You will review chart data to ensure Medicare Advantage and other risk-adjustment documentation meets CMS requirements and provide education to providers. You’ll perform code abstractions, audits, and metrics tracking, mentor new staff, and stay current with ICD-10 and HCC updates.