Risk Adjustment Coordinator

About Us:​

AbroadWorks is a fast growing global enterprise with established operations in the United States, India, and the Philippines. We specialize in providing both service-based solutions and advanced tech to help North American organizations in finding, onboarding, and managing global talent easily.

Our Offerings:

Global Staffing Services: Currently, the majority of our revenue is generated through our comprehensive global staffing services, which cater to the diverse needs of our clients.

Technology Solutions: Looking ahead, our strategic focus is to expand our footprint in the software sector, leveraging our technology to improve global human capital and talent management processes.

Job Title: Risk Adjustment Coder

Location: Fully Remote, Philippines

Rate: $5.00 - $8.00 per hour based on experience

Job Type : Full-Time

Job Description:

We are seeking an organized and detail-oriented Risk Adjustment Coordinator to support healthcare operations and risk adjustment programs. This role focuses on coordinating daily workflows, tracking chart review and coding activities, supporting provider outreach, monitoring HCC and RAF activities, preparing reports, and assisting with compliance and quality assurance initiatives.

The ideal candidate has experience in healthcare operations, care coordination, medical coding support, quality improvement, population health, or risk adjustment. You should be comfortable managing multiple workflows, maintaining tracking tools, coordinating across departments, and working independently in a remote environment.

Requirements:

1. Associate degree or equivalent experience in healthcare administration, health information management, business administration, nursing support, or a related field .
2. Minimum of 2 years of experience in healthcare operations, care coordination, medical coding support, quality improvement, population health, or risk adjustment.
3. Experience working with electronic health records (EHR/EMR) .
4. Proficiency with Microsoft Excel, Outlook, Word, and PowerPoint .
5. Strong organizational and project coordination skills with the ability to manage multiple priorities.
6. Strong attention to detail and accuracy when maintaining healthcare and operational data.
7. Ability to track deadlines, follow up on outstanding tasks, and maintain organized workflows.
8. Strong written and verbal communication skills.
9. Ability to work independently while coordinating effectively with multiple departments.
10. Understanding of HIPAA requirements and commitment to maintaining confidentiality.
11. Reliable internet connection and professional remote work setup.

Responsibilities:

1. Coordinate daily risk adjustment workflows and project activities.
2. Track completion of chart reviews, CDI reviews, provider feedback, and coding activities.
3. Maintain work queues and task assignments for coding and clinical review teams.
4. Monitor project timelines and follow up on outstanding deliverables.
5. Schedule risk adjustment meetings and maintain meeting documentation, action items, and follow-ups.
6. Support annual and quarterly risk adjustment program initiatives.
7. Assist with HCC recapture and suspected diagnosis programs.
8. Track and monitor completion of Care Foundation visits and documentation reviews.
9. Coordinate provider outreach and follow up regarding documentation opportunities.
10. Assist in identifying documentation gaps and missing diagnoses.
11. Support retrospective and prospective chart review initiatives.
12. Maintain tracking tools related to RAF, HCC capture, coding opportunities, and clinical review outcomes.
13. Generate routine and ad hoc risk adjustment reports.
14. Maintain dashboards and performance tracking tools.
15. Monitor productivity, accuracy, and completion metrics.
16. Reconcile information between chart review, coding, claims, and encounter data.
17. Prepare reports and presentations for leadership meetings.
18. Assist with data validation and quality assurance activities.
19. Assist with RADV, compliance, and internal audit preparation activities.
20. Maintain documentation and records required for audit readiness.
21. Ensure adherence to organizational policies, HIPAA requirements, and CMS guidelines.
22. Participate in quality assurance and process improvement activities.
23. Maintain meeting calendars and project plans.
24. Document workflows and standard operating procedures.
25. Coordinate communication between departments.
26. Prepare meeting agendas, summaries, and related documentation.
27. Assist with processes and projects designed to optimize risk adjustment operations.
28. Perform additional risk adjustment and operational duties as assigned.

Successful candidates for this role are expected to possess the following attributes:​​

1. Must have excellent English communication skills.
2. Has the ability to complete projects in a timely manner and quickly adjust to changing circumstances and embrace new technologies, processes, or methods.
3. Great logical and verbal reasoning skills.
4. Exceptionally detail-oriented.
5. Exceptional problem-solving and information-processing skills.
6. Ability to think outside the box.
7. A great work ethic and interest in learning new concepts and growing with the job.
8. Ability to work both independently and as part of a team.
9. Must have their own work device (preferably a desktop or laptop) and a stable internet connection.
10. Must be comfortable with using a time-tracking software for payroll purposes.
11. Must be willing to undergo a background verification check during the final stages of the hiring process.

Successful candidates for this role will be rewarded with the following benefits:

1. A total of five paid vacation days per year (additional days can be taken unpaid).
2. A 5% raise per year guaranteed (additional raises or bonuses may be given for outstanding performance).
3. A paid 15-minute break for every 4 hours of work.
4. Healthcare benefits after 2 months of full-time work.

* Vacation days increase by 1 vacation day per year. I.e. after one year of employment, the total paid vacation days on year 2 would be six, on year 3 seven, etc.

Our main focus is to build an energized and motivated workforce where our employees are happy and satisfied with their jobs and growth opportunities.

We are looking forward to making you a part of our team!

Thank you for your time and interest.