This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Risk Adjustment Coding Specialist in the United States.

This role plays a key part in ensuring accurate clinical coding and compliance within a risk adjustment framework, directly supporting quality care and proper reimbursement outcomes. You will review medical documentation, apply HCC and M.E.A.T. coding standards, and ensure alignment with CMS and payer regulations. Working in a collaborative remote environment, you will contribute to data integrity, provider documentation improvement, and coding accuracy across patient records. The position requires strong attention to detail, coding expertise, and the ability to work independently while maintaining high compliance standards. You will also support continuous education efforts and help identify opportunities to improve documentation quality. This is a mission-driven role where precision in coding directly impacts patient care reporting and organizational performance.

Accountabilities

In this role, you will be responsible for reviewing clinical documentation, applying accurate coding standards, and ensuring compliance with regulatory and payer requirements while supporting continuous improvement in documentation quality.

Review and assign accurate ICD-10-CM codes using HCC and M.E.A.T. standards for provider-documented diagnoses
Analyze clinical documentation using EHR systems and NLP tools to identify appropriate risk adjustment coding opportunities
Ensure coding accuracy and compliance with CMS, federal, state, and payer regulations
Identify documentation gaps and communicate improvement opportunities to coding auditors and clinical providers
Support provider documentation improvement initiatives and recommend enhancements to coding processes
Participate in ongoing education to maintain certification and stay current with coding standards and guidelines
Maintain adherence to confidentiality policies and safeguard sensitive patient health information
Collaborate with team members to ensure consistency, accuracy, and efficiency in coding workflows
Perform additional coding, auditing, or administrative tasks as assigned

Requirements

The ideal candidate is detail-oriented, analytical, and highly knowledgeable in medical coding standards, with the ability to manage multiple priorities in a fast-paced, compliance-driven environment.

Certified Risk Adjustment Coder (CRC) required, or CPC with CRC certification required within 12 months of hire
High school diploma or GED required
Strong understanding of ICD-10-CM coding guidelines, HCC, and M.E.A.T. standards
Knowledge of CMS regulations, payer requirements, and risk adjustment models
Excellent attention to detail and accuracy in medical coding and documentation review
Strong verbal and written communication skills
Ability to work independently and collaboratively within a team environment
Intermediate computer skills, including Word, Excel, Outlook, Teams, and typing proficiency
Strong organizational skills with the ability to manage multiple tasks and deadlines
Customer-service mindset with professionalism in communication
Ability to adapt to changing priorities and maintain focus in a remote work environment

Benefits

Competitive pay range: $24.60 – $32.80 per hour (based on experience and location)
100% remote work flexibility (with potential limited travel if local)
Comprehensive benefits package including medical, dental, and vision coverage
Paid time off and retirement benefits (where applicable)
Professional development and continuing education support for certification maintenance
Opportunity to work in a mission-driven healthcare environment
Inclusive and diverse workplace culture focused on collaboration and growth
Exposure to advanced risk adjustment tools, coding systems, and EHR technologies

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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Risk Adjustment Coding Specialist

Requirements

Benefits

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