Senior Risk Adjustment Coder, Provider Enablement - Remote

Overview

Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.

Our vision is care that enables everyone to achieve their best health. So, we’re creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality. Homeward supports Medicare-eligible beneficiaries by partnering with health plans, providers, and communities to align incentives – taking full financial accountability for clinical outcomes and the total cost of care across rural counties.

As a public benefit corporation and Certified B Corp™, Homeward’s mission and business model are aligned to address the healthcare, economic, and demographic challenges that make it challenging for rural Americans to stay healthy. Our Homeward Navigation™ platform uses advanced analytics to connect members to the right care and local resources that address social determinants of health and improve holistic health outcomes. Since many rural communities lack adequate clinical capacity, Homeward also employs care teams that supplement local practices and reach people who cannot otherwise access care.

In Short

• We are seeking a Senior Risk Adjustment Coder to join our growing team.
• This individual will review, audit, and analyze outpatient clinical documentation.
• Ensure accurate and complete coding of risk-adjustable conditions.
• Work alongside educators and managers to improve documentation quality.
• Conduct retrospective risk adjustment chart reviews using CMS-HCC and ICD-10-CM guidelines.
• Identify trends in missed coding opportunities and compliance concerns.
• Maintain expertise in CMS risk adjustment policies and coding guidelines.
• Collaborate with Provider Educators for education targeting.
• 5+ years of experience in risk adjustment coding required.
• Certified Risk Adjustment Coder (CRC) from AAPC required.

Requirements

• Ability to travel up to 20% of the time.
• Deep expertise in ICD-10-CM and CMS-HCC.
• Strong familiarity with outpatient clinical documentation.
• Demonstrated success in coding QA/auditing.
• Comfort working independently and managing tight timelines.

Benefits

• Competitive salary and equity grant.
• Unlimited Paid Time Off.
• 100% of employee premiums covered for medical, dental & vision insurance.
• Company-sponsored 401k plan.
• Ongoing professional development opportunities.