Risk Adjustment Coder
Alpine Physician Partners
full-time
Posted on:
Location Type: Hybrid
Location: Denver • Colorado • United States
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Salary
💰 $59,155 - $78,884 per year
About the role
- Conduct comprehensive retrospective and/or prospective risk adjustment chart reviews in accordance with CMS guidelines
- Identify, validate, and capture appropriate HCCs supported by documentation, including chronic condition monitoring and MEAT criteria
- Ensure diagnosis coding is accurate, specific, and compliant with ICD-10-CM and Medicare requirements
- Document findings clearly and consistently within designated systems and tools
- Support timely and accurate submission of risk adjustment codes through established workflows
- Identify documentation gaps, unsupported diagnoses, or compliance risks and escalate appropriately
- Achieves and maintains coding accuracy levels greater than 95%
- Provide clear, actionable feedback to providers and practice staff based on chart review findings
- Support structured education efforts focused on common documentation opportunities, trends, or errors identified through chart reviews
- Reinforce best practices for documentation and coding through targeted training sessions, written guidance, or job aids as needed
- Serve as a subject matter resource for questions related to risk adjustment documentation and coding standards
- Partner with clinical, operational, and analytics teams to support reporting accuracy and data integrity
- Identify recurring trends or systemic issues impacting documentation and coding accuracy
- Contribute to workflow improvements and standardization efforts related to risk adjustment processes
- Stay up to date with changes in coding, risk adjustment, and Medicare regulations
Requirements
- Certified Professional Coder (CPC)
- Certified Risk Adjustment Coder (CRC) or commitment to obtain within one year of hire
- 3–5 years of experience in medical coding, preferably Medicare Advantage risk adjustment
- Strong working knowledge of CMS and Medicare risk adjustment guidelines
- Strong knowledge of ICD-10-CM, CPT, and HCPCS coding
- Understanding of HCC categories and hierarchies
- Ability to adapt to various coding technology platforms, such as Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems and coding documentation platforms
- Strong written and verbal communication skills
- Ability to work independently with minimal supervision.
Benefits
- HIPAA-compliant home office for remote or hybrid roles, if applicable
- Occasional travel (<10%) to provider sites
- Required certifications must be maintained in accordance with company policy
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical codingrisk adjustment codingICD-10-CMCPTHCPCSHCC categoriesdocumentation accuracycoding compliancechronic condition monitoringMEAT criteria
Soft skills
communication skillsindependencefeedback provisiontrainingproblem-solvingattention to detailcollaborationadaptabilityorganizational skillsanalytical skills
Certifications
Certified Professional Coder (CPC)Certified Risk Adjustment Coder (CRC)