Senior Risk Adjustment Coder - HCC Expert & Trainer

Astrana Health; Monterey Park (CA); Hybrid; USD 80,000 - 85,000; Full time

Job summary

Astrana Health in Monterey Park, CA is seeking a Risk Adjustment coder to review and ensure accurate ICD-10-CM/HCC documentation across Medicare Advantage, ACA, and commercial lines. You will educate providers and work with IPAs to improve coding quality.

You will travel up to 75% and balance on-site fieldwork with hybrid support, maintaining up-to-date knowledge of CMS guidelines and payer requirements while meeting productivity targets.

Qualifications

• Must possess and maintain CCS/CPC certification; CRC is a plus.
• 3+ years of risk adjustment coding experience required.
• Excellent written, verbal, and presentation skills; ability to educate providers.
• Proficient with Microsoft Word, Excel, PowerPoint; EHR and coding software experience.
• Willingness to travel up to 75% of work time.

Responsibilities

• Review provider documentation to verify Medicare Advantage, ACA and Commercial risk adjustment requirements.
• Review medical records to identify and document HCC coding and related claims.
• Perform code abstraction and audits to ensure ICD-10-CM accuracy and CMS guidelines.
• Interact with physicians on coding, documentation policies, and clarifications.
• Meet productivity targets and due dates; provide audit feedback on noncompliance.
• Maintain knowledge of coding regulations and payer requirements; report risks to management.
• Provide training and mentorship to new staff and peer guidance as needed.

Skills

Healthcare coding

Interpersonal communication

Education and training

MS Office skills

EHR/coding software

Education

CCS/CPC/AHIMA cert

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Job description

Astrana Health in Monterey Park, CA is seeking a Risk Adjustment coder to review and ensure accurate ICD-10-CM/HCC documentation across Medicare Advantage, ACA, and commercial lines. You will educate providers and work with IPAs to improve coding quality.

You will travel up to 75% and balance on-site fieldwork with hybrid support, maintaining up-to-date knowledge of CMS guidelines and payer requirements while meeting productivity targets.