Supervisor - Risk Adjustment

Astrana Health, Inc.•Orange, CA

2d•$90,000 - $105,000•Hybrid

About The Position

We are seeking an experienced and motivated Risk Adjustment Coding Supervisor to oversee and support a team of Risk Adjustment Coders. This role is responsible for supervising daily coding activities, ensuring accuracy and compliance with CMS Risk Adjustment guidelines, and supporting the Manager with day-to-day operations of the Risk Adjustment department. The ideal candidate will value coaching staff and providers, and be highly data-driven, with the ability to analyze coding, audit, and performance data to identify trends, gaps, and opportunities. We are seeking candidates who have experience with provider education and who are comfortable traveling around OC/LA 25% of the time! Our Values: Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team

Requirements

At least one of the following: CCS, CCS-P, CPC, CPC-H, CPC-P, RHIA, RHIT
Minimum of 4–5 years of medical coding experience, including Risk Adjustment and HCC coding
Prior lead, senior, or supervisory experience
Strong knowledge of Medicare Advantage Risk Adjustment and Hierarchical Condition Categories (HCC)
Strong data analysis skills with the ability to interpret coding, audit, and performance metrics
Ability to identify patterns and trends within Risk Adjustment data to inform decision-making and workflow design
Experience using data to drive operational improvements and support Risk Adjustment initiatives
Advanced Excel skills preferred (e.g., pivot tables, reporting, data analysis)
Excellent verbal, written, and presentation skills
Demonstrated ability to educate and train coding staff and provider office personnel
Expert-level proficiency in Microsoft Word, Excel, Outlook, and PowerPoint
Strong organizational, analytical, and problem-solving skills
Reliable transportation and valid driver’s license
Ability to travel up to 50% of the time within Orange County, Los Angeles County, and the South Bay area.

Nice To Haves

CRC (not required but highly preferred)
Have deep expertise in Risk Adjustment and HCC coding
Are data-driven and comfortable using metrics to guide decisions and improve outcomes
Enjoy analyzing trends and patterns to enhance Risk Adjustment performance
Have experience building or refining workflows that improve coder efficiency and accuracy
Enjoy leading, mentoring, and developing coding professionals
Thrive in a fast-paced, collaborative environment
Are detail-oriented and committed to coding accuracy and compliance
Are comfortable supporting management with operational and workflow needs

Responsibilities

Team Leadership & Supervision
Supervise, coach, and mentor Risk Adjustment Coding Specialists to ensure high-quality, compliant coding practices
Serve as a resource for coders regarding ICD-10-CM, HCCs, CMS Risk Adjustment guidelines, and documentation standards
Monitor individual and team productivity, accuracy, and quality metrics; provide ongoing feedback and corrective action as needed
Utilize productivity, quality, and audit data to identify performance trends, coding gaps, and training opportunities
Translate data insights into actionable feedback, performance improvement plans, and targeted education
Assist with onboarding and training of new coding staff
Operational Support
Support the Risk Adjustment Manager with day-to-day departmental operations, including workflow coordination, prioritization of audits, and issue resolution
Assist in developing and maintaining standard operating procedures, workflows, and best practices
Analyze Risk Adjustment data (e.g., recapture rates, audit findings, productivity, denial trends) to support departmental strategy and prioritization
Collaborate with leadership to design and implement new or enhanced workflows for coders based on data, performance metrics, and operational needs
Support reporting and dashboard development to track coding performance, quality outcomes, and Risk Adjustment impact
Escalate operational, compliance, or performance issues to leadership as appropriate
Coding, Auditing & Compliance
Review provider documentation and medical records to ensure all Medicare Advantage and Commercial Risk Adjustment requirements are met
Perform and/or oversee retrospective and prospective medical record reviews to identify, assess, monitor, and document HCC coding opportunities
Conduct coding quality audits to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation
Analyze audit results to identify systemic coding or documentation trends and recommend process improvements
Prepare audit analyses and provide feedback on noncompliance or documentation improvement opportunities
Provider & Staff Education
Interact with physicians and provider office staff regarding coding, billing, and documentation policies and procedures
Deliver education and training on Risk Adjustment and documentation improvement, both individually and in group settings
Assist with the development of educational materials and presentations, including PowerPoint content
Other duties as assigned