Risk Adjustment Coding Advisor

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Requirements:

• Current AAPC CRC certification or AHIMA RAC microcredential.
• Prior experience working in healthcare, especially healthcare consulting.
• Experience working with and developing HCC medical coding guidelines, documentation requirements, and audit programs.
• Working knowledge of anatomy/physiology, disease process, and medical terminology.
• Familiarity with medications and reimbursement guidelines.
• A proven ability to communicate effectively across domains and experience levels.
• Drive to innovate, identify novel approaches, and act decisively.
• Fluency in productivity tools like Microsoft (Excel, Powerpoint) and Google Suite (Sheets, Docs, etc.).

Responsibilities:

• Working with clients to establish and maintain risk adjustment coding accuracy thresholds.
• Reviewing and auditing medical records and physician documentation for HCC accuracy.
• Conducting strategic analysis and scenario modeling across functional disciplines.
• Tracking, aggregating and summarizing coding and billing rules for the product team.
• Collaborating with engineering, product, and customer success teams on client roadmap.
• Providing coding education and training to internal engineering and product teams.
• Preparing executive presentations and reports for internal and external audiences.
• Developing and enhancing internal and client-facing analytics and reporting.