Certified Risk Coder

Certified Risk CoderThe Certified Risk Coder plays a critical role in supporting Astrana Health's value-based care and risk adjustment initiatives by ensuring the accurate capture and validation of diagnoses through comprehensive medical record review and coding analysis. This position partners closely with providers and clinical teams to improve documentation quality, coding accuracy, and compliance with CMS risk adjustment guidelines. The ideal candidate brings strong coding expertise, a passion for provider education, and a commitment to enhancing organizational performance through accurate risk capture, regulatory compliance, and continuous process improvement.Our Values:Put Patients FirstEmpower Entrepreneurial Provider and Care TeamsOperate with Integrity & ExcellenceBe InnovativeWork As One TeamWhat You'll DoReview medical records and provider documentation to ensure accurate capture of risk-adjusting diagnoses and compliance with CMS guidelinesPerform retrospective and prospective HCC coding reviews to identify documentation and coding opportunitiesValidate ICD-10-CM codes and ensure diagnoses are clinically supported and accurately reportedConduct coding audits and quality reviews to maintain documentation integrity and regulatory compliancePartner with providers and clinical teams to improve documentation accuracy and risk adjustment performanceDeliver one-on-one and group education sessions on coding, documentation, and risk adjustment best practicesCommunicate audit findings, coding trends, and improvement opportunities to providers and leadershipStay current on ICD-10-CM, HCC, CMS Risk Adjustment, and payer-specific coding requirementsSupport process improvement initiatives that enhance coding accuracy, compliance, and operational efficiencyServe as a coding resource and mentor to team members, supporting training and knowledge sharing across the organizationParticipate in special projects, departmental initiatives, and high-volume work efforts as assignedQualificationsCertified Risk Adjustment Coder (CRC) credentialAt least two (2) years of risk adjustment, HCC coding, medical coding, or related healthcare experienceWorking knowledge of Medicare Advantage Risk Adjustment and Hierarchical Condition Categories (HCC)Proficiency with ICD-10-CM coding guidelines and CMS Risk Adjustment methodologiesExperience using Electronic Health Records (EHRs), coding software, and Microsoft Office applicationsExcellent communication and presentation skills with the ability to educate providers and office staffStrong analytical, organizational, and problem-solving skills with exceptional attention to detailAbility to work independently in a remote environment while collaborating effectively with cross-functional teamsYou are a great fit if:Active AAPC or AHIMA certification required (CPC, CCS-P, CCS, or equivalent)Three (3)+ years of Risk Adjustment or Medicare Advantage coding experienceExperience conducting coding audits and documentation reviewsExperience educating providers on coding and documentation improvement initiativesPrevious experience supporting value-based care, population health, or provider group environmentsAdvanced presentation and PowerPoint skillsEnvironmental Job Requirements and Working ConditionsThis is a remote, US based position - Strong preference for candidates based in West or Central time zonesThe annual total compensation target pay range for this role is $56,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factorsAstrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at View email address on click.appcast.io to request an accommodation.The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.About Astrana Health, Inc.Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient. Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.