Risk Adjustment Analyst

Job Description

Job Description

Risk Adjustment Specialist – Primary Care

Location: Remote
Employment Type: Full-Time

Pay : $65K - $75K

About Us

Here at Physician Care Centers, we are a patient-centered primary care organization committed to delivering high-quality, value-based care. Our team partners with providers to improve patient outcomes while ensuring accurate clinical documentation and coding practices.

Position Overview

We are seeking a detail-oriented Risk Adjustment Specialist to support our value-based care initiatives. In this role, you will work closely with providers and clinical teams to ensure accurate documentation and coding of patient conditions, helping reflect the true complexity of our patient population.

What You’ll Do

• Perform pre-visit and post-visit chart reviews to identify risk adjustment opportunities
• Ensure accurate ICD-10-CM and HCC coding based on clinical documentation
• Partner with providers to clarify diagnoses and improve documentation quality
• Educate providers and staff on risk adjustment and coding best practices
• Track and monitor Risk Adjustment Factor (RAF) scores and performance metrics
• Support internal and external audits and ensure compliance with Centers for Medicare & Medicaid Services (CMS) guidelines
• Stay current on coding updates and value-based care requirements

What We’re Looking For

• 2+ years of experience in risk adjustment, medical coding, or primary care
• Strong knowledge of ICD-10-CM and HCC coding
• Certification such as CRC or CPC preferred
• Experience working with electronic health records (EHRs)
• Excellent attention to detail and analytical skills
• Strong communication skills and ability to collaborate with providers

Why Join Us?

• Competitive salary and benefits package
• Opportunity to work in a growing value-based care environment
• Collaborative and supportive team culture
• Professional development and certification support