Astrana Health

Technology-enabled platform delivering value-based care

Certified Risk Coder

Clinical Support & Patient AdministrationUpdated on Nov 13

Full-timeMonterey Park, CA, USA$56k - $85k /yrRemote

About the Job

Requirements

At least two years of risk adjustment, HCC coding, medical coding, or related healthcare experience.
Working knowledge of Medicare Advantage Risk Adjustment and Hierarchical Condition Categories (HCC).
Proficiency with ICD-10-CM coding guidelines and CMS Risk Adjustment methodologies.
Experience using Electronic Health Records (EHRs), coding software, and Microsoft Office applications.
Ability to educate providers and office staff, supported by communication and presentation skills.
Strong analytical, organizational, and problem-solving skills, with attention to detail.
Ability to work independently in a remote environment while collaborating with cross-functional teams.

Responsibilities

Review medical records and provider documentation to ensure accurate capture of risk-adjusting diagnoses and compliance with CMS guidelines.
Perform retrospective and prospective HCC coding reviews to identify documentation and coding opportunities.
Validate ICD-10-CM codes and ensure diagnoses are clinically supported and accurately reported.
Conduct coding audits and quality reviews to maintain documentation integrity and regulatory compliance.
Partner with providers and clinical teams to improve documentation accuracy and risk adjustment performance.
Deliver one-on-one and group education sessions on coding, documentation, and risk adjustment best practices.
Communicate audit findings, coding trends, and improvement opportunities to providers and leadership.
Stay current on ICD-10-CM, HCC, CMS Risk Adjustment, and payer-specific coding requirements.
Support process improvement initiatives that enhance coding accuracy, compliance, and operational efficiency.
Serve as a coding resource and mentor to team members, supporting training and knowledge sharing across the organization.
Participate in special projects, departmental initiatives, and high-volume work efforts as assigned.

Desired Qualifications

Three or more years of Risk Adjustment or Medicare Advantage coding experience.
Experience conducting coding audits and documentation reviews.
Experience educating providers on coding and documentation improvement initiatives.
Previous experience supporting value-based care, population health, or provider group environments.
Advanced presentation and PowerPoint skills.

The 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 First
Empower Entrepreneurial Provider and Care Teams
Operate with Integrity & Excellence
Be Innovative
Work As One Team

Review medical records and provider documentation to ensure accurate capture of risk-adjusting diagnoses and compliance with CMS guidelines
Perform retrospective and prospective HCC coding reviews to identify documentation and coding opportunities
Validate ICD-10-CM codes and ensure diagnoses are clinically supported and accurately reported
Conduct coding audits and quality reviews to maintain documentation integrity and regulatory compliance
Partner with providers and clinical teams to improve documentation accuracy and risk adjustment performance
Deliver one-on-one and group education sessions on coding, documentation, and risk adjustment best practices
Communicate audit findings, coding trends, and improvement opportunities to providers and leadership
Stay current on ICD-10-CM, HCC, CMS Risk Adjustment, and payer-specific coding requirements
Support process improvement initiatives that enhance coding accuracy, compliance, and operational efficiency
Serve as a coding resource and mentor to team members, supporting training and knowledge sharing across the organization
Participate in special projects, departmental initiatives, and high-volume work efforts as assigned

Certified Risk Adjustment Coder (CRC) credential
At least two (2) years of risk adjustment, HCC coding, medical coding, or related healthcare experience
Working knowledge of Medicare Advantage Risk Adjustment and Hierarchical Condition Categories (HCC)
Proficiency with ICD-10-CM coding guidelines and CMS Risk Adjustment methodologies
Experience using Electronic Health Records (EHRs), coding software, and Microsoft Office applications
Excellent communication and presentation skills with the ability to educate providers and office staff
Strong analytical, organizational, and problem-solving skills with exceptional attention to detail
Ability to work independently in a remote environment while collaborating effectively with cross-functional teams

You 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 experience
Experience conducting coding audits and documentation reviews
Experience educating providers on coding and documentation improvement initiatives
Previous experience supporting value-based care, population health, or provider group environments
Advanced presentation and PowerPoint skills

About the Company

Astrana Health

Technology-enabled platform delivering value-based care

Astrana Health runs a physician-focused, technology-enabled care platform that supports providers in delivering proactive, preventive, value-based care. Its end-to-end system coordinates care across affiliated networks, a management services organization, and primary, specialty, and ancillary clinics to help more than 20,000 providers and over 1.6 million Americans in value-based arrangements. How it works: the proprietary platform connects clinicians, patients, and care settings, enabling proactive care planning, care coordination, and efficient delivery of services in primary and specialty care. The company differentiates itself by combining a large provider network, an MSO, and clinics with a single tech platform to scale value-based care and improve patient experiences and outcomes rather than relying on fragmented, fee-for-service models. Its goal is to create a healthcare system that delivers better care, better experiences, and better outcomes for all.

Company size: 501-1,000
Company stage: Not listed
Total funding: Not listed
Headquarters: Alhambra, CA
Founded: Not listed

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