Senior ICD-10 Risk Adjustment Specialist

Viva-Health; Birmingham (AL); On-site; USD 85,000 - 105,000; Full time

Benefits offered by this job

Health Coverage

401(k) match

PTO

Holidays

Tuition Assistance

Flexible Spending Accounts

Life Insurance

Wellness Program

Training and Development

Job summary

VIVA HEALTH, part of the UAB Health System, seeks a Senior Risk Adjustment Specialist to review medical records for accurate ICD-10-CM coding and CMS submission readiness. The role supports risk adjustment initiatives and acts as a subject matter expert for the team.

The position requires strong coding knowledge, documentation interpretation, and the ability to mentor staff while driving process improvements and compliance with RADV audits.

Qualifications

• Demonstrate knowledge of ICD-10 coding guidelines and medical terminology.
• Identify and document clinically supported diagnoses for CMS-HCC.
• Communicate provider coding concerns and education needs.
• Mentor and train new Risk Adjustment Specialists.
• Assist management with workflow improvements and risk-related projects.

Responsibilities

• Review medical records to ensure ICD-10-CM codes are accurate and compliant.
• Provide subject matter expertise to Risk Adjustment specialists.
• Query providers to obtain clarification for unclear documentation.
• Collaborate with providers on coding changes and documentation questions.
• Support RADV audits and related compliance activities.

Skills

ICD-10-CM coding

Medical terminology

Analytical thinking

Communication skills

Leadership

Education

AHIMA or AAPC certification

High School Diploma or GED

2+ years college

Job description

VIVA HEALTH, part of the UAB Health System, seeks a Senior Risk Adjustment Specialist to review medical records for accurate ICD-10-CM coding and CMS submission readiness. The role supports risk adjustment initiatives and acts as a subject matter expert for the team.

The position requires strong coding knowledge, documentation interpretation, and the ability to mentor staff while driving process improvements and compliance with RADV audits.