Senior Risk Adjustment Coding Specialist

Astrana Health, Inc.; Orange (CA); Hybrid; USD 72,000 - 85,000; Full time

Benefits offered by this job

Hybrid work model

Up to 75% travel

Job summary

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II in Orange County to support risk adjustment efforts across our provider network.

You will conduct high-volume chart reviews to identify coding gaps, deliver provider education, and track KPIs such as HCC recapture rates and AWVs. The role involves travel to provider offices up to 75% and requires AAPC/AHIMA certification with at least 3 years of experience.

Qualifications

• CCS-P/CCS/CPC certifications from AAPC or AHIMA required.
• Minimum 3 years of risk adjustment coding or billing experience.
• Willingness to travel up to 75% and valid driver's license.
• Proficient with Microsoft Word, Excel, and Outlook.

Responsibilities

• Review documentation to verify Medicare Advantage, ACA, and Commercial risk adjustment requirements and educate providers.
• Review medical records for HCC coding consistency and documentation.
• Perform code abstraction and coding quality audits to ensure ICD-10-CM coding accuracy.
• Interact with physicians on coding, billing, and documentation policies.
• Prepare auditing analyses and report noncompliance findings.

Skills

CCS-P

CCS

CPC

Risk adjustment

PowerPoint

Public speaking

Tools

Microsoft Word

Excel

Outlook

Job description

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II in Orange County to support risk adjustment efforts across our provider network.

You will conduct high-volume chart reviews to identify coding gaps, deliver provider education, and track KPIs such as HCC recapture rates and AWVs. The role involves travel to provider offices up to 75% and requires AAPC/AHIMA certification with at least 3 years of experience.