Senior Risk Adjustment Coder (CRC) – Remote & Quality Impact

AAPC; United States; Remote; USD 70,000 - 100,000; Full time

Job summary

HealthPartners is seeking a Senior Risk Adjustment Coding Analyst to lead retrospective chart reviews for diagnosis coding accuracy and to ensure accurate representation of population risk for plan performance.

The role includes reviewing vendor coding, delivering education to providers, supporting CMS data validation, and driving process improvements across the risk adjustment workflow while protecting patient information and complying with regulations.

Qualifications

• Five years of diagnosis coding review as a certified coder.
• Knowledge of CPT, ICD-9, ICD-10 and revenue cycle processes.
• Identify issues and drive retrospective chart review improvements.
• Understand clinical documentation requirements for correct coding.
• Strong communication and team collaboration skills.

Responsibilities

• Performs retrospective chart review for diagnosis coding accuracy.
• Identifies, analyzes, and reports coding error trends to inform risk adjustment analytics and education.
• Reviews vendor coding and provides feedback to vendor team.
• Participates in CMS risk adjustment data validation review.
• Develops training and educational seminars on risk adjustment topics.
• Collaborates with Health Partners Health Plan and Medical Group on coding optimization.
• Analyzes complex information for leadership reporting.
• Maintains confidentiality and compliance with regulations.
• Increases organizational efficiency in daily operations.
• Responsible for other duties as assigned.

Skills

Risk adjustment coding

Communication

Organizational skills

Team collaboration

Adaptability

Education

RHIA

RHIT

CPC

CCS

CCS-P

CRC

Four year college degree

Associate's degree in related field

Tools

Microsoft Word

Excel

Job description

HealthPartners is seeking a Senior Risk Adjustment Coding Analyst to lead retrospective chart reviews for diagnosis coding accuracy and to ensure accurate representation of population risk for plan performance.

The role includes reviewing vendor coding, delivering education to providers, supporting CMS data validation, and driving process improvements across the risk adjustment workflow while protecting patient information and complying with regulations.