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Risk Adjustment Coding Specialist
Risk Adjustment Coding Specialist-March 2024
San Juan
Mar 28, 2026
About Risk Adjustment Coding Specialist

Job ID Number

R4378

Employment Type

Full time

Worksite Flexibility

Remote

Job Summary

We are looking for a motivated Risk Adjustment Coding Specialist ready to take us to the next level! If you have at least 5 years of experience with Hierarchical Condition Category Coding, certifications in Risk Adjustment, and are looking for your next career move, apply now.

Job Description

We are looking for a Risk Adjustment Coding Specialist to collaborate with physicians and team members across multiple departments to identify and deliver high quality risk adjustment coding. This position will be Full-Time and Remote.

Due to our end client and project work, all candidates must be United States citizens.

What You’ll Do

Perform HCC coding on projects for MA, ACA, and ESRD

Ability to quickly flex between coding projects, including Retrospective coding, with different MA, ESRD, and ACA HCC Models

Ability to work independently in various coding applications and electronic medical record systems to support departmental goals

Adheres to CMS Guidelines for Coding and Clients policy and procedures to guide HCC coding decision making

Maintains at least 95% coding accuracy and productivity requirements

Assist with Regulatory Audits by performing first coding review and ranking of charts. Build partnerships and work within coding teams and internal partners critical to HCC coding

Participate on ad-hoc projects per the direction of Leadership to address the needs of the department. Provide recommendations for process improvements and efficiencies

Fully engages in RAAM Coding educational meetings and annual coding conference

Other duties as assigned

What You'll Need

Required:

Associate degree in healthcare with 5 years of relevant work experience performing Hierarchical Condition Category (HCC) Coding

Must have one of the following certifications: CRC, CPC, CCS, RHIT

Experience utilizing MS Office Suite: MS Teams, Outlook, Excel, PowerPoint, Word

Excellent communication, both written and verbal

Previous remote working experience

Preferred:

Bachelor's degree with 5 years of relevant work experience performing HCC Coding

7 years in HCC Coding and Healthcare experience

NLP Coding

Experience with V28 HCC Model

Physical Demands

Ability to safely and successfully perform the essential job functions consistent with the ADA and other federal, state, and local standards

Sedentary work that involves sitting or remaining stationary most of the time with occasional need to move around the office to attend meetings, etc.

Ability to conduct repetitive tasks on a computer, utilizing a mouse, keyboard, and monitor

Must be able to communicate with customers/team members in over the phone and in person

#LI-NA1

Reasonable Accommodation Statement

If you require a reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employment selection process, please direct your inquiries to [email protected] or (888) 824 – 8111.

Equal Employment Opportunity Policy Statement

It is the policy of CAI not to discriminate against any employee or applicant due to race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or being a protected veteran. It is also the policy of CAI to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or being a protected veteran, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Employees and applicants of CAI will not be subject to harassment due to race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or being a protected veteran. Additionally, retaliation, including intimidation, threats, or coercion, because an employee or applicant has objected to discrimination, engaged or may engage in filing a complaint, assisted in a review, investigation, or hearing or have otherwise sought to obtain their legal rights under any Federal, State, or local EEO law is prohibited.

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