Alpine Physician Partners
Risk Adjustment Coding Analyst
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Job Description
- Req#: R0001616
- Minimum of three years’ experience in risk adjustment coding. Preferred five years of experience in health care coding.
- Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent certification required.
- Strong knowledge of ICD-10-CM coding guidelines, HCC coding, and CMS regulations.
- Experience conducting audits and validations for risk adjustment accuracy.
- Excellent analytical skills with attention to detail in medical documentation.
- Strong communication and collaboration skills for provider education.
- Ability to handle multiple tasks with a high level of accuracy.
- Detail-oriented and organized.
- Strong work ethic.
- Experience with Medicare Advantage, Medicaid, or Affordable Care Act risk adjustment programs.
- Familiarity with EHR systems like Elation and Athena, and AI applications like Ambiance.
- Ability to interpret regulatory changes and apply them to coding practices.
We're committed to bringing passion and customer focus to the business.
Job Description:
We are seeking a Certified Risk Adjustment Coding Analyst to support accurate medical coding and ensure compliance with risk adjustment guidelines. This role plays a vital part in optimizing coding accuracy for ASAS Health while supporting revenue integrity and regulatory compliance. The ideal candidate will have a strong background in medical coding, risk adjustment methodologies, and data validation processes.
ESSENTIAL FUNCTIONS:
Medical Coding: Accurately assign diagnostic codes (ICD-10-CM) from clinical documentation following risk adjustment guidelines (Medicare Advantage, Medicaid, ACA, etc.).
Compliance & Accuracy: Ensure coding adheres to official coding guidelines, payer policies, and regulatory standards.
Chart Reviews: Conduct audits of medical records to verify code accuracy, identify discrepancies, and support compliance efforts.
Provider & Team Support: Collaborate with physicians, billers, coders, and clinician teams to enhance documentation and educate on risk adjustment best practices.
Data Analysis: Monitor coding trends, conduct data validation, and generate reports to assess risk scores and financial impact.
Continuous Learning: Stay up to date with regulatory changes, coding guidelines, and industry updates affecting risk adjustment coding. Always maintain active coding certification.
EDUCATION and EXPERIENCE
KNOWLEDGE, SKILLS, and ABILITIES:
If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!
About the company
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