Senior HCC Coding & Risk Adjustment Analyst

Altais Health Solutions; Oakland (CA); On-site; USD 34,000 - 41,000; Full time

Job summary

Altais is seeking a Senior Coding Analyst, Risk Adjustment, to focus on HCC coding for Medicare Advantage programs and other risk-adjustment initiatives. You will train providers, ensure documentation aligns with ICD-10/HCC guidelines, and collaborate with physicians and clinical staff to optimize coding accuracy.

The role involves auditing, education, and support across IDV, RADV, OIG, and DMHC activities, with potential engagement across Commercial and Medicaid lines.

Qualifications

• Minimum 2 years of HCC coding experience.
• 3–5 years of professional medical coding experience (CPC/CRC or similar).
• 3–5 years in HCC coding and auditing (chart review).
• 1+ years in EPIC EMR software.
• 1+ years project management or coordinating detailed projects.

Responsibilities

• Review, audit, and code medical records for HCC reimbursement, training, and compliance.
• Meet daily productivity targets with 95% accuracy.
• Audit and review medical documentation for ICD-10 and HCC coding; query physicians when needed.
• Review codes annually for accuracy and implement changes.
• Assist physicians with questions on HCC coding and documentation.
• Support internal data validation, RADV, OIG, and DMHC audits.
• Serve as a resource to team members and physician offices.
• Role may allocate 50%+ of time to production.

Skills

HCC coding

Medical coding

Project coordination

Team collaboration

Education

High school diploma or GED

CPC/CRC certification

Bachelor’s degree preferred

Tools

EPIC EMR

Job description

Altais is seeking a Senior Coding Analyst, Risk Adjustment, to focus on HCC coding for Medicare Advantage programs and other risk-adjustment initiatives. You will train providers, ensure documentation aligns with ICD-10/HCC guidelines, and collaborate with physicians and clinical staff to optimize coding accuracy.

The role involves auditing, education, and support across IDV, RADV, OIG, and DMHC activities, with potential engagement across Commercial and Medicaid lines.