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Certified Risk Adjustment Coder
Location
California
Posted
129 days ago
Salary
$24 - $27 / hour
Seniority
Junior
Job Description
Certified Risk Adjustment Coder
Habitat Health
• Review participant medical records and provider documentation to identify, validate, and code risk-adjustable diagnoses in accordance with CMS-HCC v24 and v28 guidelines. • Ensure complete, accurate, and compliant ICD-10-CM coding with a primary focus on concurrent and retrospective reviews (with flexibility for pre-visit planning as needed). • Draft and submit compliant provider queries to clarify documentation and support accurate coding. • Track and follow through on open queries—engaging with providers, monitoring responses, and closing them out appropriately. • Apply strong critical thinking skills to resolve complex documentation and coding scenarios. • Maintain clear, professional communication with providers and internal teams to support documentation completeness. • Stay current with CMS, OIG, and industry regulations related to risk adjustment and coding compliance.
Job Requirements
- Active CRC (Certified Risk Adjustment Coder) required.
- Minimum of 1 year of experience in risk adjustment coding.
- In-depth knowledge of ICD-10-CM and CMS-HCC models v24 and v28.
- Demonstrated ability to work independently, stay organized, and follow through on tasks with minimal oversight.
- Strong written and verbal communication skills, with the ability to engage providers in a professional and solutions-oriented manner.
- High attention to detail and ability to critically analyze clinical documentation.
- Proficiency with electronic health records (EHR) and Microsoft Excel.
- Aligns with our purpose and our values, and is excited about living those out in daily practice
Benefits
- Medical/dental/vision insurance
- Short and long-term disability
- Life insurance
- Flexible spending accounts
- 401(k) savings
- Paid time off
- Company-paid holidays
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