Coding Analyst, Care Delivery Organization - Fully remote
Core
Hands-on HCC coder and provider enablement resource for a Care Delivery Organization, delivering accurate risk adjustment codes and education to improve clinical documentation quality.
Role type
Senior IC medical coding analyst (Risk Adjustment/HCC)
Builds
Accurate CMS Risk Adjustment submissions and improved clinical documentation standards for contracted physician partners
Domain
Healthcare / Medicare Advantage / Risk Adjustment
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
ICD-10-CM coding, HCC coding, Risk Adjustment methodology, prospective and retrospective chart review, EHR systems, clinical documentation integrity, audit readiness, productivity management
Preferred skills
High-volume Medicare Advantage experience, CMS RADV audit familiarity, productivity tracking tools, AAPC/AHIMA certifications
Technologies
ICD-10-CM, CMS-HCC model, EHR platforms, coding workflow platforms
Responsibilities
Review medical records and assign compliant HCC codes for CMS Risk Adjustment submissions; conduct structured audits of provider documentation to identify gaps and inaccuracies; develop and deliver targeted education on coding standards and documentation best practices to providers; flag unsupported diagnoses and missing conditions to close risk capture gaps; apply current CMS coding guidelines and policies to ensure compliance; meet daily productivity targets and maintain quality benchmarks; stay current on ICD-10-CM updates and HCC model changes
Seniority
Mid-level, hands-on IC
