Risk Adjustment Coder

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

This role plays a key part in ensuring the accuracy, completeness, and compliance of clinical documentation and medical coding within a value-based care environment. You will collaborate closely with physicians, clinical staff, and internal teams to review medical records and identify risk adjustment and quality gap opportunities. Your work directly supports improved patient outcomes, more accurate severity-of-illness capture, and stronger data integrity across the organization. The position requires a detail-oriented professional who can interpret complex clinical documentation and apply coding guidelines with precision. You will also contribute to provider education by identifying documentation trends and supporting improvement initiatives. This is a highly impactful role where coding expertise translates directly into better care quality and operational performance.

Accountabilities:

In this role, you will review and analyze clinical documentation to ensure accurate risk adjustment coding and compliance with regulatory standards while supporting quality improvement initiatives.

• Review medical records, including histories, progress notes, diagnostic reports, and discharge summaries to validate ICD-10-CM coding accuracy and compliance.
• Identify missing, incomplete, or unsupported diagnoses and initiate provider queries to ensure proper documentation.
• Analyze clinical indicators to capture severity of illness and ensure appropriate risk adjustment scoring.
• Conduct chart reviews to identify opportunities for improving coding accuracy and member risk adjustment profiles.
• Monitor documentation trends and communicate findings to internal stakeholders to support training and improvement efforts.
• Ensure adherence to federal, state, and organizational coding guidelines and regulatory requirements.
• Collaborate with physicians and clinical teams to improve documentation quality and completeness.

Requirements:

The ideal candidate brings strong clinical knowledge, coding expertise, and the ability to work accurately in a fast-paced healthcare environment.

• High school diploma or GED required; coding certification (CRC, AHIMA, or AAPC preferred or equivalent experience).
• 2+ years of experience in risk adjustment coding or primary care clinical coding environment.
• Strong knowledge of ICD-10-CM, CPT, medical terminology, anatomy, physiology, and disease processes.
• Ability to interpret complex medical records and apply coding guidelines with high accuracy.
• Experience using electronic medical record (EMR) systems and Microsoft Office tools (especially Excel).
• Strong organizational skills with the ability to manage high workloads and meet strict deadlines.
• Excellent communication skills for provider queries, documentation feedback, and internal collaboration.
• High attention to detail, dependability, and ability to work independently with minimal supervision.
• Comfort working in hybrid arrangements, including occasional in-office presence and limited travel.

Benefits:

• Hourly pay range: $24.00 – $34.25
• Performance-based bonus eligibility (depending on role structure and outcomes)
• Comprehensive medical, dental, and vision insurance options
• Opportunities for professional growth and career advancement in value-based care
• Supportive, mission-driven environment focused on improving senior healthcare outcomes
• Training and development in medical coding and population health documentation practices
• Flexible work arrangements with potential hybrid/remote eligibility
• Employee wellness and work-life balance programs

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. #LI-CL1