Risk Adjustment QA Coder - Remote

Overview

We’re looking for a Risk Adjustment QA Coder to ensure the highest standards of accuracy in coding and documentation. In this role, you’ll apply your expertise across chart reviews, diagnostic validation, and compliance checks to safeguard quality at every step. You’ll also partner with our data science, engineering and product teams to make our platform more precise and reliable over time.

In Short

• Conduct pre-visit chart reviews to confirm documentation is complete and supports accurate coding
• Validate post-visit recommendations generated by our AI, ensuring clinical alignment and precision.
• Assign ICD-10-CM and CPT codes with accuracy and consistency, following established risk adjustment guidelines.
• Identify coding discrepancies and provide structured feedback to enhance model performance and UI clarity.
• Support internal audits and compliance processes to maintain rigorous quality standards.
• Continuously track coding updates and regulatory changes to keep practices current and exact.

Requirements

• Certification as a CPC, CCS, CRC, or equivalent credential preferred.
• Experience in risk adjustment coding with a track record of accuracy and reliability.
• Deep understanding of clinical documentation and medical terminology.
• Exceptional attention to detail with strong analytical skills.
• Clear communicator with a collaborative mindset, especially in cross-functional work.
• Skilled in EMRs and coding software, with comfort adopting new tools to improve precision.

Benefits

• Shape the quality standards of AI-powered risk adjustment.
• Join a team driven by accuracy, integrity, and impact.
• Competitive compensation and benefits package.
• Fully remote, flexible work environment.
• Experience in the healthcare technology industry, preferably in a software development environment.
• Deep understanding of the regulatory environment affecting healthcare compliance (HIPAA, etc.)
• Strong leadership skills with the ability to motivate and guide a diverse team.
• Excellent communication skills, capable of effectively articulating complex medical and technical information to a variety of stakeholders.