Risk Adjustment Analyst
PCC MEDICAL HOLDINGS LLC
•Remote
About The Position
We are seeking a detail-oriented Risk Adjustment Specialist to support our value-based care initiatives. In this role, you will work closely with providers and clinical teams to ensure accurate documentation and coding of patient conditions, helping reflect the true complexity of our patient population.
Requirements
- 2+ years of experience in risk adjustment, medical coding, or primary care
- Strong knowledge of ICD-10-CM and HCC coding
- Experience working with electronic health records (EHRs)
- Excellent attention to detail and analytical skills
- Strong communication skills and ability to collaborate with providers
Nice To Haves
- Certification such as CRC or CPC preferred
Responsibilities
- Perform pre-visit and post-visit chart reviews to identify risk adjustment opportunities
- Ensure accurate ICD-10-CM and HCC coding based on clinical documentation
- Partner with providers to clarify diagnoses and improve documentation quality
- Educate providers and staff on risk adjustment and coding best practices
- Track and monitor Risk Adjustment Factor (RAF) scores and performance metrics
- Support internal and external audits and ensure compliance with Centers for Medicare & Medicaid Services (CMS) guidelines
- Stay current on coding updates and value-based care requirements
Benefits
- Competitive salary and benefits package
- Opportunity to work in a growing value-based care environment
- Collaborative and supportive team culture
- Professional development and certification support
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
11-50 employees
