[Hiring] Manager of Coding and Risk Adjustment @214bf51a-c332-4680-9417-17fe2278d7e4

Role Description

The Manager of Coding and Risk Adjustment is responsible for leading coding operations, risk adjustment initiatives, quality assurance activities, and provider documentation improvement efforts. This position oversees coding staff, coding quality programs, provider education initiatives, and risk adjustment performance across multiple markets and lines of business. The Manager serves as the subject matter expert for ICD-10 coding, CMS-HCC risk adjustment, Medicare Advantage, HEDIS, STARS, and coding compliance while ensuring departmental goals, coding accuracy standards, and operational performance metrics are achieved.

The Manager of Coding & Risk Adjustment collaborates closely with executive leadership, clinical providers, quality teams, and operational leaders to improve documentation integrity, maximize accurate reimbursement, support value-based care initiatives, and ensure regulatory compliance. This position is fully remote.

Qualifications

• Five (5) years of ICD-10 coding experience.
• Three (3) years of Medicare Advantage and Risk Adjustment coding experience.
• Two (2) years of leadership, mentoring, supervisory, or management experience.
• Experience conducting coding audits and quality assurance reviews.
• Experience providing provider education and documentation improvement support.
• Strong knowledge of ICD-10-CM Coding, CMS-HCC Risk Adjustment Methodology, Medicare Advantage, Medicaid Risk Adjustment, HEDIS, STARS, RAF Scoring, Provider Documentation Improvement (PDI), and CMS Documentation Guidelines.
• Knowledge of EMR platforms and healthcare technology systems.
• Knowledge of claims, encounters, billing processes, and healthcare reimbursement models.
• Strong analytical, organizational, and problem-solving skills.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.

Requirements

• High School Diploma or GED required.
• Bachelor's degree in healthcare administration, health information management, business administration, nursing, or a related field preferred.
• Active Certified Risk Adjustment Coder (CRC) credential required.
• CPC, CCS, RHIT, RHIA, or additional coding certification preferred.
• Experience with Salesforce or other CRM platforms preferred.

Benefits

• Paid Orientation and Training
• Insurance – Medical, Dental, Vision, and Life
• 401k Plan – 3% match
• Employee Assistance Program
• Tuition Reimbursement
• Continued Education Support
• Mileage Reimbursement (if applicable)
• Referral Bonuses
• Paid Holidays (9 days)
• Paid Time Off (20 days)
• Paid Volunteer Hours