Risk Adjustment Medical Coder, Fully Remote

Centauri Health Solutions
18hRemote

About The Position

Centauri delivers data-driven technology solutions that transform fragmented clinical and member data into actionable intelligence — maximizing accuracy, quality performance, and outcomes for health plans and health systems. Through close collaboration with our customers, Centauri improves patient and member outcomes by providing advocacy, advanced data insights, and intelligent clinical data delivery. The company addresses critical healthcare challenges for complex populations and improves access and quality of care. Headquartered in Tempe, Arizona, Centauri Health Solutions employs 1100 dedicated associates across the country and has been recognized on the Inc. 5000 list, the 2020 Deloitte Technology Fast 500™, and has been recognized as 2026 Best in KLAS for ADT Notifications. Role Overview The Risk Adjustment Coder with AHIMA or AAPC certification performs medical record diagnosis code abstraction based upon clinical documentation, ICD-10-CM Official Guidelines for Coding and Reporting, AHA Coding Clinic Guidance, CMS program guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The Risk Adjustment Coder will apply guidance provided for the medical record code abstraction primarily for Medicaid lines of business (Complete Code Capture), but may also include Medicare Advantage Risk Adjustment or Commercial Risk Adjustment. Certified through AHIMA or AAPC required.(CRC, CPC, CCS, CCS-P Certification Required)

Requirements

  • Minimum of 3 years certified with a core coding credential from AHIMA or AAPC
  • Must be one of the following (CRC, CPC, CCS, CCS-P)
  • Experience and proficiency working with Medicaid plans 1+ years
  • Strong organizational skills
  • Technical savvy with high level of competence in basic computers, Microsoft Outlook, Word, and Excel
  • Strong written and verbal communication skills
  • Ability to work independently in a remote environment
  • Minimum of 1 recent year of production coding experience in Retrospective Risk Adjustment coding (must be within last 6 months)
  • Required code set knowledge and coding experience in Medicaid (primary), Medicare, and Commercial benefit plans
  • Minimum of 1 year coding experience with Complete Code Capture

Responsibilities

  • Perform code abstraction of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation
  • Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education
  • Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations
  • Ability to pass coding quiz with 80% accuracy
  • Consistently maintain a minimum 95% accuracy on coding quality audits
  • Meet minimum productivity requirements as outlined by the project terms
  • Ability to adhere to client guidelines when superseding other guidelines
  • Assist coding leadership by making recommendations for process improvements to further enhance coding goals and outcomes
  • Handle other related duties as required or assigned

Benefits

  • We believe strongly in providing employees a rewarding work environment in which to grow, excel and achieve personal as well as professional goals.
  • Centauri provides training and the computer equipment needed for this role.
  • We offer our employees competitive compensation and a comprehensive benefits package that includes paid time off, a matching 401(k) program, tuition reimbursement, annual salary reviews, a comprehensive health plan, the opportunity to participate in volunteer activities on company time, and development opportunities.
  • This position is bonus eligible in accordance with the terms of the Company’s plan.
  • Factors which may affect starting pay within this range may include geography/market, skills, education, experience and other qualifications of the successful candidate.
  • Centauri Health Solutions is an equal opportunity employer and is committed to providing reasonable accommodations to qualified individuals with disabilities in accordance with applicable law.
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