Supervisor – Risk Adjustment
Astrana Health
full-time
Posted on:
Location Type: Hybrid
Location: Houston • Texas • United States
Visit company websiteExplore more
Salary
💰 $80,000 - $90,000 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
Requirements
- Minimum of 4–5 years of medical coding experience, including Risk Adjustment and HCC coding
- Prior lead, senior, or supervisory experience
- Certified Coding Specialist (CCS or CCS-P) OR Certified Professional Coder (CPC)
- Certified Risk Adjustment Coder (CRC) (not required but highly preferred)
- 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
- Ability to identify patterns and trends within Risk Adjustment data to inform decision-making and workflow design
- Experience using data to drive operational improvements and support Risk Adjustment initiatives
- Excellent verbal, written, and presentation skills
- Expert-level proficiency in Microsoft Word, Excel, Outlook, and PowerPoint
- Strong organizational, analytical, and problem-solving skills
- Reliable transportation and valid driver’s license
- Ability to travel up to 75% of the time within the designated markets, primarily Houston, with travel to Beaumont and San Antonio as needed.
Benefits
- Our organization follows a hybrid work structure where the expectation is to work both onsite and at home on a weekly basis. Up to 75% travel is required in designated market(s).
- 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.
- The total compensation target pay range for this role is $80,000 - $90,000 per year. The salary range represents our national target range for this role. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical codingRisk Adjustment codingHCC codingICD-10-CMdata analysiscoding auditsperformance metricsdocumentation standardsaudit findingscoding quality
Soft Skills
coachingmentoringcommunicationorganizational skillsanalytical skillsproblem-solvingpresentation skillsfeedback deliveryteam collaborationtraining
Certifications
Certified Coding Specialist (CCS)Certified Coding Specialist - Physician (CCS-P)Certified Professional Coder (CPC)Certified Risk Adjustment Coder (CRC)