Risk Adjustment Coding Specialist II

About the role

You will support risk adjustment work across a Northern California market by reviewing charts at high volume and turning findings into provider education. The role tracks performance metrics and helps improve coding accuracy.

What you will do

• Conduct high volume chart reviews to find coding gaps, trends and accuracy opportunities
• Review diagnostic documentation to confirm Medicare Advantage, ACA and commercial risk adjustment requirements are met
• Abstract codes and audit records so ICD-10-CM assignments are supported by clinical documentation
• Discuss coding, billing and documentation matters with physicians, including unclear records
• Report on metrics such as HCC recapture rates and annual wellness visits
• Mentor new staff and guide peers on projects and daily work

What they look for

• Current AAPC or AHIMA certification such as CPC, CCS or CCS-P
• At least three years of risk adjustment coding or billing experience
• Willingness to travel to provider offices, with reliable transport and a valid driver license
• Proficiency with Microsoft Word, Excel and Outlook plus coding software and EHR systems
• Strong presentation and communication skills for training provider office staff