Coding Consultant

About IntusCare
IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen financial performance, and stay compliant. IntusCare replaces outdated technology and manual workarounds with purpose-built solutions for care coordination, risk adjustment, population health, and utilization management. We empower teams to take control of their operations and improve outcomes for dual-eligible seniors- some of the most socially vulnerable and clinically complex individuals in the US healthcare system.

Job Description

The Coding Consultant is responsible for delivering high-quality, accurate risk adjustment coding services for Intus Care’s IRIS clients. This role is focused exclusively on coding workflows—reviewing medical records, identifying diagnosis codes, validating documentation, and ensuring compliance with CMS-HCC and risk adjustment standards.

This position does not include training, consulting, workflow design, or direct provider education responsibilities. Instead, the Coding Consultant is dedicated to ensuring coding accuracy, consistency, and timeliness across all IRIS coding deliverables.

Key Responsibilities

Risk Adjustment Coding

• Review medical records to assign all applicable diagnosis codes following , ICD-10-CM Official Guidelines, AHA Coding Clinic guidance, and IRIS internal coding policies.

• Conduct PEP (Pre-Encounter Preparation) coding and concurrent coding workflows as assigned.

• Document coding rationales clearly and consistently in accordance with IRIS standards.

• Maintain strict adherence to CMS requirements, audit preparedness, and risk adjustment integrity.

Quality & Compliance

• Maintain a coding accuracy score of 95% or higher, with a strong commitment to continuous quality improvement.

• Participate in internal audits, peer reviews, and periodic quality checks.

• Ensure compliance with documentation requirements, CMS risk adjustment standards, and RADV audit expectations.

• Flag documentation inconsistencies or incomplete provider documentation for clinical review.

Workflow & Productivity

• Complete assigned coding volumes within established productivity targets.

• Meet deadlines for all coding deliverables to ensure timely client reporting and monthly cycles.

• Utilize IntusCare’s IRIS tools, dashboards, and platforms to complete coding tasks efficiently and accurately.

• Follow structured workflows and escalate issues when documentation is unclear or unavailable.

Cross-Functional Collaboration

• Collaborate with IRIS team members—including Senior Consultants, Project Managers, and Data Analysts—when coding clarification or workflow adjustments are needed.

• Communicate coding questions or potential documentation improvements to the appropriate internal contacts (not directly to providers).

• Participate in team meetings to stay aligned on monthly cycles, product updates, and coding standards.

Qualifications

Required Certifications

• CPC, CCS, RHIT, or CRC (Certified Risk Adjustment Coder) required.

Experience

• Minimum 3–5 years of medical coding experience, preferably in risk adjustment or HCC coding.

Education

• High school diploma required; Associate’s or Bachelor’s degree preferred.

Skills & Competencies

• Strong knowledge of CMS-HCC models, diagnosis coding guidelines, and RAF scoring.

• High attention to detail and accuracy.

• Ability to work independently in a remote, deadline-driven environment.

• Proficiency with EMR/EHR systems and coding platforms.

• Strong written communication skills for documenting coding decisions.

Compensation: The base salary range for this role is $75-90K. We expect the ideal candidate to fall near the midpoint of this range, though final compensation will be determined based on experience, skills, and organizational needs. Final compensation will also include a variable component and stock options.

Work location: This is a fully remote role based in the United States.

Sponsorship: This position is not eligible for sponsorship.