Senior Risk Adjustment Coder II – Advanced Medical Coding

Harris Health; Houston (TX); On-site; USD 65,000 - 90,000; Full time

Job summary

Community Health Choice is a nonprofit managed care organization serving Texas. The Risk Adjustment Coder II will review complex medical records, code chronic conditions, and map to HCCs under CMS guidelines.

The role supports Commercial and Medicare risk adjustment programs and helps ensure accurate documentation and coding. The coder will contribute to trainings, audits, and collaboration across departments to improve documentation quality and compliance.

Qualifications

• Bachelor’s Degree or 5+ years of risk adjustment experience in lieu of a degree.
• AHIMA/AAPC certified coder with Medical Billing and Coding certification (CPC/CRC/COC/CCS/CCS-P).
• 3–5 years of Commercial or Medicare risk adjustment coding experience.
• Proficiency with Microsoft 365 (Word, Excel, Outlook, SharePoint, Teams).
• Inpatient/outpatient clinical documentation improvement experience is preferred.

Responsibilities

• Provide advanced complex medical records reviews and code all relevant diagnoses using ICD-10 for risk adjustment programs.
• Map diagnoses to Hierarchical Condition Categories (HCCs) per CMS guidelines and internal policies.
• Identify opportunities to improve documentation and coding accuracy; present recommendations to leadership.
• Meet productivity and quality standards as set by supervision.
• Stay current with coding standards and CMS changes to ensure ongoing compliance.
• Collaborate with multiple departments on risk adjustment initiatives and trainings.

Skills

Microsoft 365

Education

Bachelor’s Degree

AHIMA/AAPC Certification

Medical Billing and Coding Certification (CPC/CRC/COC/CCS/CCS-P)

Tools

Microsoft 365

Job description

Community Health Choice is a nonprofit managed care organization serving Texas. The Risk Adjustment Coder II will review complex medical records, code chronic conditions, and map to HCCs under CMS guidelines.

The role supports Commercial and Medicare risk adjustment programs and helps ensure accurate documentation and coding. The coder will contribute to trainings, audits, and collaboration across departments to improve documentation quality and compliance.