Senior Risk Adjustment Coding Specialist | HCC Expert

Astrana Health, Inc.; Northern, San Diego (KY, CA); Hybrid; USD 72,000 - 85,000; Full time

Job summary

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support the Orange County market. You will review diagnostic data, code quality, and education for providers, while tracking KPIs and contributing to program success.

Ideal candidates have risk adjustment experience and are prepared to travel up to 75% to provider offices. This full-time role offers a hybrid work structure and competitive compensation in the US market.

Qualifications

• Must possess and maintain AAPC or AHIMA certification (CCS-P/CCS/CPC).
• 3 years of risk adjustment coding and/or billing experience required.
• Willingness to travel up to 75% of work time.
• Proficient with Microsoft Word, Excel, and Outlook.
• Ability to educate and train provider office staff and colleagues.

Responsibilities

• Review provider documentation to verify Medicare Advantage, ACA, and Commercial risk adjustment requirements; deliver education to providers.
• Review medical records to identify HCC-related coding issues; document claims and encounters.
• Perform code abstraction and coding quality audits to ensure accurate ICD-10-CM coding.
• Interact with physicians regarding coding, billing, and documentation policies.
• Prepare auditing analyses and provide feedback on noncompliance issues.

Skills

PowerPoint

Public speaking

Team collaboration

Provider education

Education/training staff

Education

AAPC/AHIMA CCS-P/CCS/CPC

CPB (APPC)

Tools

Microsoft Word

Microsoft Excel

Outlook

EHR systems

Healthcare coding software

Monday.com

Job description

Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support the Orange County market. You will review diagnostic data, code quality, and education for providers, while tracking KPIs and contributing to program success.

Ideal candidates have risk adjustment experience and are prepared to travel up to 75% to provider offices. This full-time role offers a hybrid work structure and competitive compensation in the US market.