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Certified Risk Adjustment Coder

Medical Billing and CodingMedical Billing and CodingOtherRemoteJuniorTeam 1-10Since 2023H1B No SponsorCompany SiteLinkedIn

Location

California

Posted

129 days ago

Salary

$24 - $27 / hour

Seniority

Junior

Professional Certificate1 yr expEnglish

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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