Role Description The Coder Abstractor is responsible for the charge capture process for professional charges within the Munson system, including but not limited to: - Verifying and/or analyzing medical record and/or encounter form documentation to determine the principal and all secondary diagnoses and procedures. - Assigning diagnostic codes, procedural codes, and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS) and Munson. - Performing data entry and discrepancy resolution. - Serving as a liaison between CBO and sites/departments. - Assisting in the orientation and training of new employees within the coding and charge capture area. - Reviewing office-based electronic charges and encounter forms for completion and accuracy, including accuracy of ICD9/10CM, CPT, and HCPCS modifier assignment. - Reviewing and interpreting physician documentation of surgical procedures to accurately assign and enter billing codes. - Working with the central billing team to ensure charges are coded and entered within two business days. - Identifying educational needs and/or compliance issues and reporting them to the Director of Central Billing Office. - Resolving coding discrepancies related to coding and revenue capture. - Serving as an expert resource for physicians, office management staff, and central billing staff. - Researching and responding to coding and compliance questions, coordinating accurate assignment of procedure codes and modifiers. - Performing other duties as assigned. Qualifications - Associate’s degree in Health Record Technology, or related healthcare field and two years of professional coding experience, and must obtain the credentials of a Certified Professional Coder (CPC), Registered Health Information Administrator (RHIT), or Registered Health Information Administrator (RHIA) within 18 months of employment. - OR three years of professional coding experience and has obtained the credentials of a certified professional coder (CPC), Registered Health Information Administrator (RHIT), or Registered Health Information Administrator (RHIA). - OR four to five years of professional coding experience and must obtain the credentials of a certified professional coder (CPC), Registered Health Information Administrator (RHIT), or Registered Health Information Administrator (RHIA) within 18 months of employment. Requirements - Fully remote! Must have at least two years of cardiology coding. - Munson Healthcare requires all employees to be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella, and Varicella. - MHC also requires all employees to receive a flu vaccine during the flu season in the year that they are hired and annually thereafter, or receive an approved medical or religious exemption. - Shift: Day Shift - Status: Full Time Benefits - Tuition reimbursement, in-person and online development, and access to our career hub to help you advance. - Full benefits, paid holidays, generous PTO, employee discounts, and free individual retirement counseling. - Free wellness platform for you and your family, plus personalized support for personal or family challenges. - Share your ideas and help shape the way we work through improvement huddles, employee surveys, and town hall meetings.

• Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company. • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC). • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines. • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation. • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing. • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements. • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives. • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work. • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager. • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I. • Other duties as assigned.

• Deliver efficient and accurate coding services on behalf of member clients • Extract and interpret relevant clinical data from patient medical records and electronic health systems • Review and analyze patient encounters to assign appropriate diagnosis and procedure codes • Support member organizations in achieving appropriate reimbursement by reviewing and recommending accurate code assignments • Conduct research and obtain additional information from providers or clinical staff as needed

Role Description We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Houston market. In this role, you will support risk adjustment efforts by: - Conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. - Tracking and reporting on key performance metrics—such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success. We are seeking candidates who have experience with at least 3 years of risk adjustment experience and reside in an area that operates in the central time zone. Qualifications - Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification - Certified Coding Specialist (CCS-P), CCS, or CPC. - At least 3 years of experience in risk adjustment coding and/or billing experience required. - Reliable transportation/Valid Driver’s License/Must be able to travel up to 75% of work time. - PC skills and experience using Microsoft applications such as Word, Excel, and Outlook. - Excellent presentation, verbal and written communication skills, and ability to collaborate. - Must possess the ability to educate and train provider office staff members. - Proficiency with healthcare coding software and Electronic Health Records (EHR) systems. Requirements - Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC. - Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience. - Knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage. - Strong PowerPoint and public speaking experience. - Ability to work independently and collaborate in a team setting. - Experience with Monday.com. - Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting. Benefits - The national target pay range for this role is $55,000 - $70,000 per year. Actual compensation will be determined based on geographic location, experience, and other job-related factors. - This is a remote position. Candidates must live in an area within the central time zone. Company Description Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.