{"schemaVersion":"jobsearcher.job.v1","id":"56eb7efe4d67550fb5e1dbca","url":"https://jobsearcher.com/jobs/56eb7efe4d67550fb5e1dbca","canonicalUrl":"https://jobsearcher.com/jobs/56eb7efe4d67550fb5e1dbca","title":"Senior Risk Adjustment Coder (Remote)","description":"OverviewSenior Risk Adjustment Coder drives accurate risk adjustment coding through retrospective audits, chart reviews, and provider education. You partner with physicians and teams to improve documentation specificity and RAF accuracy, supporting onboarding and ongoing education. You'll lead audits, share findings, and serve as a subject matter expert on PBACO tools, shaping risk adjustment performance across targeted programs. This role blends auditing, education, and collaboration to uphold compliance and revenue integrity.ResponsibilitiesConduct retrospective documentation audits to verify diagnosis capture, coding accuracy, and CMS guidelines compliancePerform two-sided chart reviews to find documentation gaps and opportunities for recaptureEvaluate medical records for complete support of diagnoses and M.E.A.T. criteria where applicableDevelop and deliver physician education on documentation integrity, HCC capture, and coding guidelinesSupport onboarding of new PCPs with education and one-on-one guidanceProvide ongoing education to PCPs based on audit trends and regulatory updatesTrack audit outcomes and collaborate with stakeholders to improve coding accuracy and program performanceAct as subject matter expert on PBACO risk adjustment tools and pre-visit/concurrent capabilitiesPartner with PES department to drive risk adjustment improvementsKey requirements4+ years of risk adjustment coding and/or auditing experienceCRC, CPC, or CDEO certification required; multiple certifications preferredBachelor's degree preferredStrong knowledge of HCC methodology (CMS-HCC, HHS-HCC) and ICD-10-CM coding guidelinesExperience with auditing complex medical records and applying coding guidanceExcellent communication and education skills for presenting findings to physicians and staffProficiency with EHR systems, coding tools, audit workflows, and Microsoft Office (Excel, PowerPoint)excellent communicationstrong organizational skillsability to manage multiple audits and deadlinesCMS-HCC, HHS-HCC, ICD-10-CMEHR systemscoding tools","company":"Adp Automatic Data Processing","rawCompany":"adp automatic data processing","city":"Brooklyn","state":"NY","isRemote":true,"isActive":false,"createdAt":"2026-10-26T13:22:30.496Z","occupations":[{"code":"29-9021.00","title":"Health Information Technologists and Medical Registrars","slug":"health-information-technologists-and-medical-registrars"},{"code":"29-2072.00","title":"Medical Records Specialists","slug":"medical-records-specialists"},{"code":"11-9199.02","title":"Compliance Managers","slug":"compliance-managers"}],"industries":[{"code":"621111","title":"Offices of Physicians (except Mental Health Specialists)","slug":"offices-of-physicians-except-mental-health-specialists"},{"code":"621999","title":"All Other Miscellaneous Ambulatory Health Care Services","slug":"all-other-miscellaneous-ambulatory-health-care-services"},{"code":"622110","title":"General Medical and Surgical Hospitals","slug":"general-medical-and-surgical-hospitals"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Senior Risk Adjustment Coder (Remote)","description":"OverviewSenior Risk Adjustment Coder drives accurate risk adjustment coding through retrospective audits, chart reviews, and provider education. You partner with physicians and teams to improve documentation specificity and RAF accuracy, supporting onboarding and ongoing education. You'll lead audits, share findings, and serve as a subject matter expert on PBACO tools, shaping risk adjustment performance across targeted programs. This role blends auditing, education, and collaboration to uphold compliance and revenue integrity.ResponsibilitiesConduct retrospective documentation audits to verify diagnosis capture, coding accuracy, and CMS guidelines compliancePerform two-sided chart reviews to find documentation gaps and opportunities for recaptureEvaluate medical records for complete support of diagnoses and M.E.A.T. criteria where applicableDevelop and deliver physician education on documentation integrity, HCC capture, and coding guidelinesSupport onboarding of new PCPs with education and one-on-one guidanceProvide ongoing education to PCPs based on audit trends and regulatory updatesTrack audit outcomes and collaborate with stakeholders to improve coding accuracy and program performanceAct as subject matter expert on PBACO risk adjustment tools and pre-visit/concurrent capabilitiesPartner with PES department to drive risk adjustment improvementsKey requirements4+ years of risk adjustment coding and/or auditing experienceCRC, CPC, or CDEO certification required; multiple certifications preferredBachelor's degree preferredStrong knowledge of HCC methodology (CMS-HCC, HHS-HCC) and ICD-10-CM coding guidelinesExperience with auditing complex medical records and applying coding guidanceExcellent communication and education skills for presenting findings to physicians and staffProficiency with EHR systems, coding tools, audit workflows, and Microsoft Office (Excel, PowerPoint)excellent communicationstrong organizational skillsability to manage multiple audits and deadlinesCMS-HCC, HHS-HCC, ICD-10-CMEHR systemscoding tools","datePosted":"2026-10-26T13:22:30.496Z","dateModified":"2026-10-26T13:22:30.496Z","hiringOrganization":{"@type":"Organization","name":"Adp Automatic Data Processing","sameAs":"https://jobsearcher.com"},"jobLocationType":"TELECOMMUTE","applicantLocationRequirements":{"@type":"Country","name":"US"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Brooklyn","addressRegion":"NY","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"56eb7efe4d67550fb5e1dbca"},"url":"https://jobsearcher.com/jobs/56eb7efe4d67550fb5e1dbca"}}