Remote: Senior Risk Adjustment Coding Specialist II

Astrana Health, Inc.; Monterey Park (CA); On-site; USD 70,000 - 85,000; Full time

Job summary

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support risk adjustment efforts across provider practices. The role involves chart reviews to identify coding gaps, delivering education to providers, and tracking KPIs such as HCC recapture and AWVs.

Travel to provider offices in the Houston area is required twice weekly. The ideal candidate will have 3–5 years of risk adjustment experience, AAPC CPC and CRC certifications, and strong communication skills for provider

Qualifications

• Must possess and maintain AAPC CPC and CRC certification.
• At least 3 years of risk adjustment coding and/or billing experience.
• At least 1 year of experience with targeted provider education.
• Reliable transportation/Travel up to 75% of work time.
• Proficiency with Microsoft Word, Excel, and Outlook.
• Proficiency with healthcare coding software and EHR systems.

Responsibilities

• Review provider documentation to verify Medicare Advantage, ACA, and Commercial risk adjustment documentation.
• Review medical record information to identify and document HCC coding.
• Perform coding quality audits to ensure ICD-10-CM codes are supported by documentation.
• Interact with physicians regarding coding, billing, and documentation policies.
• Prepare/audit analyses and provide feedback on noncompliance issues.
• Stay current with ICD-10, HCC, and payer requirements.
• Train and mentor new employees and support staff.

Education

AAPC CPC CRC certification

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

EHR systems

Healthcare coding software

Job description

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support risk adjustment efforts across provider practices. The role involves chart reviews to identify coding gaps, delivering education to providers, and tracking KPIs such as HCC recapture and AWVs.

Travel to provider offices in the Houston area is required twice weekly. The ideal candidate will have 3–5 years of risk adjustment experience, AAPC CPC and CRC certifications, and strong communication skills for provider