Certified Risk Adjustment Coder; Medical

We are seeking a detail-oriented Certified
Risk Adjustment Coder to join our healthcare team. This role involves working directly within a clinical or administrative unit to ensure accurate and compliant coding of medical procedures, diagnoses, and services. The ideal candidate will be embedded in day-to-day operations, collaborating closely with physicians, nurses, and billing staff to support efficient documentation and reimbursement processes.

This is a hybrid role, and requires 3 days a week in the office

• Review and analyze patient medical records to assign appropriate ICD-10, CPT, and HCPCS codes.
• Ensure coding accuracy and compliance with federal regulations, payer policies, and internal standards.
• Collaborate with healthcare providers to clarify documentation and resolve coding discrepancies.
• Submit coded data to billing systems to initiate insurance claims and support reimbursement.
• Maintain and update patient data for long-term tracking and reporting.
• Participate in audits and quality reviews to ensure coding integrity.
• Stay current with changes in medical coding guidelines, CMS updates, and payer requirements.
• Support internal compliance and contribute to external audit readiness.

• Minimum 2–3 years of experience in medical risk adjustment coding, preferably in an embedded or integrated healthcare setting.
• Familiarity with value-based care and risk-bearing contracts.
• Strong understanding of medical terminology, anatomy, and disease classification systems.
• Proficiency with Electronic Health Records (EHR) and coding software.
• Working knowledge of Microsoft Office.
• Excellent attention to detail and analytical skills.
• Ability to work collaboratively in a fast-paced clinical environment.

• Experience with inpatient, outpatient, or specialty coding.
• Ability to engage with providers.
• Familiarity with payer-specific coding requirements and reimbursement processes.
• Strong communication skills for cross-functional collaboration.
• Knowledge of HIPAA and confidentiality protocols.