Medicare Risk Adjustment Specialist I

On Belay Health Solutions

Medicare Risk Adjustment Coding Specialist supporting AI-driven chart reviews and risk adjustment programs at On Belay Health Solutions. Reviewing and validating coding opportunities, ensuring compliance and accuracy.

Posted 6/24/2026full-timeRemote • Massachusetts • 🇺🇸 United StatesJuniorMid-Level💰 $25 - $28 per hourWebsite

About the role

Key responsibilities & impact

Review and validate AI-identified risk adjustment coding opportunities within medical records
Assess clinical documentation to determine the appropriateness of proposed diagnoses and HCC submissions
Support the quality assurance process for AI-assisted chart reviews by identifying coding discrepancies, false positives, and missed opportunities
Develop feedback loop with On Belay’s Head of Risk Adjustment Coding and physician offices On Belay supports, including but not limited to: Identification of quality improvement opportunities in individual physician coding
Any other related duties assigned at manager’s discretion

Requirements

What you’ll need

High school diploma or GED required
Associates degree preferred
Active coding certificate required
AAPC or AHIMA coding certification preferred
Required: CCS-P (Certified Coding Specialist- Physicianbased) or CPC (Certified Professional Coder)
Preferred: CRC (Certified Risk Adjustment Coder)
Experience in a primary care setting highly preferred
Knowledge of medical terminology and medical chart review required
Two (2) or more years’ experience of hierarchical condition categories (HCC)
Knowledge of ICD-10-CM Official Guidelines for Coding and Reporting
Knowledge of AHA Coding Clinic and authoritative coding resources
Knowledge of Microsoft Office suite, primarily Excel (specifically Pivot Tables, sort and filter functions)
Strong time management skills required
Ability to navigate within various EMRs (Electronic Medical Records), Cerner Preferred
Strong interpersonal, communication (verbal, non-verbal and listening) skills
Ability to remain productive under time constraints and meet deadlines critical to the business.

Benefits

Comp & perks

Innovative, revolutionary environment
Great culture with a strong sense of mission and community
Eleven (11) Paid Holidays
Lavish PTO accrual
Advancement opportunities & professional skills training
Strong referral bonus program
And more!

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

codingrisk adjustment codingHCCICD-10-CMmedical terminologychart reviewhierarchical condition categoriesquality assurancecoding discrepanciesfeedback loop

Soft Skills

time managementinterpersonal skillscommunication skillsproductivity under time constraintsability to meet deadlines

Certifications

coding certificateCCS-PCPCCRCAAPC certificationAHIMA certification