Certified Risk Adjustment Coder
Skills
- Active CRC certification and hands-on risk adjustment coding experience
- In-depth knowledge of ICD-10-CM and CMS-HCC models v24 and v28
- Experience with EHR systems and proficiency in Microsoft Excel
- Strong written and verbal communication for provider engagement
- High attention to detail and strong critical thinking for documentation analysis
- Ability to work independently in a remote environment and manage tasks with minimal oversight
Responsibilities
- Review participant medical records and provider documentation to identify, validate, and code risk-adjustable diagnoses per CMS-HCC v24 and v28 guidelines
- Perform concurrent and retrospective ICD-10-CM coding, with occasional pre-visit planning as needed
- Draft, submit, and track compliant provider queries to clarify documentation and support accurate coding
- Manage open queries: follow up with providers, monitor responses, and close queries appropriately
- Apply critical thinking to resolve complex documentation and coding scenarios
- Maintain professional communication with providers and internal teams to improve documentation completeness
- Stay up to date with CMS, OIG, and industry regulations related to risk adjustment and coding compliance
Education
- Active CRC (Certified Risk Adjustment Coder)
- Coding training or equivalent clinical coding education
- Familiarity with clinical documentation standards
Benefits
- Medical, dental, and vision insurance
- Short- and long-term disability and life insurance
- Flexible spending accounts (FSA)
- 401(k) savings plan
- Paid time off and company-paid holidays
- Bonus eligibility
Average salary estimate
If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.
Habitat Health is hiring a Senior Project Manager to lead complex healthcare projects and ensure timely, compliant delivery as the organization expands into new markets.
Visa is hiring a Staff Software Test Engineer to lead test architecture, automation and continuous testing for large-scale, cloud-native payments services.
Work as a part-time Afternoon Grain Inspector at Eurofins performing grain sampling, grading, testing, and client communication to support accurate and timely laboratory operations.
Sentec is hiring a Supplier Quality Engineer to oversee supplier qualification, audits, and continuous improvement for electromechanical and injection-molded components in a regulated medical device environment.
AECOM is hiring a CEI Senior Inspector in Miami to lead field inspection, construction layout, and quality assurance for roadway and bridge projects.
UMass Memorial Health is hiring a remote Inpatient Coding Validator to validate DRG, ICD, and CPT coding accuracy and support coding quality, reporting, and education.
A Mechanical QCx Engineer is needed to lead welding and piping QA/QC and support commissioning activities at a cutting-edge semiconductor fab in New Albany, Ohio.
Experienced QA & Security Engineer needed to lead automated functional, regression, and security testing for federal systems and ensure compliance with FedRAMP, FISMA, and Section 508 requirements.
Education at Work is hiring a seasonal Quality Assurance Analyst to evaluate calls, analyze performance data, and deliver recommendations to improve compliance and customer experience.
Apply your Copado CRT and Salesforce automation expertise to build robust, scalable test suites that validate security, UX, and data integrity across Gravie’s Salesforce implementations.
Lead the Quality Engineering team at Henry Schein to define and execute automation, performance, and quality strategies across web, mobile, and API platforms.
Radformation is hiring a Senior QA Automation Engineer to lead test automation and verification efforts for mission-driven medical software in a fully remote environment.
Amity Foundation is hiring a Contract Compliance Manager to lead QA and compliance oversight for TPA subrecipients serving re-entry populations in Los Angeles.
Northwestern Medicine seeks an RN Clinical Quality Documentation Specialist I to collaborate with clinicians and quality teams to improve documentation accuracy and translate clinical data into better quality outcomes.
🔮
Hi, I'm Risa! Your AI Career Copilot
you, just ask me below!
