Certified Risk Adjustment Coder

Habitat Health•Alameda, CA

1d•$24 - $27•Remote

About The Position

At Habitat Health, we envision a world where older adults experience an independent and joyful aging journey in the comfort of their homes, enabled by access to comprehensive health care. Habitat Health provides personalized, coordinated clinical and social care as well as health plan coverage through the Program of All-Inclusive Care for the Elderly (“PACE”) in collaboration with our leading healthcare partners, including Kaiser Permanente. Habitat Health offers a fully integrated experience that brings more good days and a sense of belonging to participants and their caregivers. We build engaged, fulfilled care teams to deliver personalized care in our centers and in the home. And we support our partners with scalable solutions to meet the health care needs and costs of aging populations. Habitat Health is growing, and we’re looking for new team members who wish to join our mission of redefining aging in place. To learn more, visit https://www.habitathealth.com. Role Scope: We are looking for a Certified Risk Adjustment Coder who is passionate about supporting accurate and compliant documentation for our PACE participants. This role requires a self-starter who thrives in an independent, remote environment, with strong critical thinking skills and a drive to deliver the highest quality outcomes. The ideal candidate will have hands-on expertise in both CMS-HCC v24 and v28 models and the ability to apply coding standards across multiple workflows.

Requirements

Active CRC (Certified Risk Adjustment Coder) required.
Minimum of 1 year of experience in risk adjustment coding.
In-depth knowledge of ICD-10-CM and CMS-HCC models v24 and v28.
Demonstrated ability to work independently, stay organized, and follow through on tasks with minimal oversight.
Strong written and verbal communication skills, with the ability to engage providers in a professional and solutions-oriented manner.
High attention to detail and ability to critically analyze clinical documentation.
Proficiency with electronic health records (EHR) and Microsoft Excel.
Aligns with our purpose and our values, and is excited about living those out in daily practice

Nice To Haves

Experience as a risk adjustment coder in PACE, long-term care, or complex care populations.
Background in clinical documentation improvement (CDI) or coding quality assurance.
Experience with Epic/OCHIN systems.

Responsibilities

Review participant medical records and provider documentation to identify, validate, and code risk-adjustable diagnoses in accordance with CMS-HCC v24 and v28 guidelines.
Ensure complete, accurate, and compliant ICD-10-CM coding with a primary focus on concurrent and retrospective reviews (with flexibility for pre-visit planning as needed).
Draft and submit compliant provider queries to clarify documentation and support accurate coding.
Track and follow through on open queries—engaging with providers, monitoring responses, and closing them out appropriately.
Apply strong critical thinking skills to resolve complex documentation and coding scenarios.
Maintain clear, professional communication with providers and internal teams to support documentation completeness.
Stay current with CMS, OIG, and industry regulations related to risk adjustment and coding compliance