Astrana Health

Supervisor – Risk Adjustment

Astrana Health

full-time

Posted on:

Location Type: Hybrid

Location: Orange • California • United States

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Salary

💰 $90,000 - $105,000 per year

About the role

  • Supervise, coach, and mentor Risk Adjustment Coding Specialists to ensure high-quality, compliant coding practices
  • Serve as a resource for coders regarding ICD-10-CM, HCCs, CMS Risk Adjustment guidelines, and documentation standards
  • Monitor individual and team productivity, accuracy, and quality metrics; provide ongoing feedback and corrective action as needed
  • Utilize productivity, quality, and audit data to identify performance trends, coding gaps, and training opportunities
  • Translate data insights into actionable feedback, performance improvement plans, and targeted education
  • Assist with onboarding and training of new coding staff
  • Support the Risk Adjustment Manager with day-to-day departmental operations, including workflow coordination, prioritization of audits, and issue resolution
  • Assist in developing and maintaining standard operating procedures, workflows, and best practices
  • Analyze Risk Adjustment data (e.g., recapture rates, audit findings, productivity, denial trends) to support departmental strategy and prioritization
  • Collaborate with leadership to design and implement new or enhanced workflows for coders based on data, performance metrics, and operational needs
  • Support reporting and dashboard development to track coding performance, quality outcomes, and Risk Adjustment impact
  • Escalate operational, compliance, or performance issues to leadership as appropriate
  • Review provider documentation and medical records to ensure all Medicare Advantage and Commercial Risk Adjustment requirements are met
  • Perform and/or oversee retrospective and prospective medical record reviews to identify, assess, monitor, and document HCC coding opportunities
  • Conduct coding quality audits to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation
  • Analyze audit results to identify systemic coding or documentation trends and recommend process improvements
  • Prepare audit analyses and provide feedback on noncompliance or documentation improvement opportunities
  • Interact with physicians and provider office staff regarding coding, billing, and documentation policies and procedures
  • Deliver education and training on Risk Adjustment and documentation improvement, both individually and in group settings
  • Assist with the development of educational materials and presentations, including PowerPoint content
  • Other duties as assigned

Requirements

  • At least one of the following: CCS, CCS-P, CPC, CPC-H, CPC-P, RHIA, RHIT
  • Minimum of 4–5 years of medical coding experience, including Risk Adjustment and HCC coding
  • Prior lead, senior, or supervisory experience
  • Strong knowledge of Medicare Advantage Risk Adjustment and Hierarchical Condition Categories (HCC)
  • Strong data analysis skills with the ability to interpret coding, audit, and performance metrics
  • Reliable transportation and valid driver’s license
  • Ability to travel up to 50% of the time within Orange County, Los Angeles County, and the South Bay area.
Benefits
  • Our organization follows a hybrid work structure. This position will be predominantly remote outside of 25% travel to the office and to provider offices throughout LA/OC/South Bay.
  • The home office of this department is located at 600 City Parkway West, 10th Floor, Orange, CA 92868.
  • Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on 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 based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at **humanresourcesdept@astranahealth.com** to request an accommodation.
  • Additional Information: 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.
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
ICD-10-CMHCC codingdata analysiscoding auditsmedical record reviewsperformance metricsdocumentation standardscompliancecoding practicesRisk Adjustment
Soft Skills
supervisioncoachingmentoringcommunicationcollaborationfeedbacktrainingproblem-solvingorganizational skillsleadership
Certifications
CCSCCS-PCPCCPC-HCPC-PRHIARHIT