Risk Adjustment Coding Specialist II - REMOTE (CST/EST)

About the role

We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Houston market.

Responsibilities

• Support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers.
• Translate findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations.
• Track and report on key performance metrics such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success.

Qualifications

• Certification/Licensure: Must possess and maintain AAPC certification, CPC and CRC.
• Experience: At least 3 years of experience in risk adjustment coding and/or billing experience required. At least 1 year of experience with targeted provider education.
• Skills: Reliable transportation/Valid Driver’s License, must be able to travel up to 75% of work time. PC skills and experience using Microsoft applications such as Word, Excel, and Outlook. Excellent presentation, verbal and written communication skills, and ability to collaborate. Proficiency with healthcare coding software and Electronic Health Records (EHR) systems. Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC. Knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage. Strong PowerPoint and public speaking experience. Ability to work independently and collaborate in a team setting. Experience with Monday.com. Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting.

Our Values

Put Patients First
Empower Entrepreneurial Provider and Care Teams
Operate with Integrity & Excellence
Be Innovative
Work As One Team