The Role
The Risk Adjustment Coding Supervisor oversees a coding team, ensuring compliance with guidelines, analyzing data trends, and providing education. Responsible for operational support and improving coding accuracy and efficiency.
Summary Generated by Built In
We are seeking an experienced and motivated Risk Adjustment Coding Supervisor to oversee and support a team of Risk Adjustment Coders. This role is responsible for supervising daily coding activities, ensuring accuracy and compliance with CMS Risk Adjustment guidelines, and supporting the Manager with day-to-day operations of the Risk Adjustment department.
The ideal candidate will value coaching staff and providers, and be highly data-driven, with the ability to analyze coding, audit, and performance data to identify trends, gaps, and opportunities.
We are seeking candidates who have experience with provider education and who are comfortable traveling around Inland Empire and San Diego ~50% of the time!
Our Values:
The ideal candidate will value coaching staff and providers, and be highly data-driven, with the ability to analyze coding, audit, and performance data to identify trends, gaps, and opportunities.
We are seeking candidates who have experience with provider education and who are comfortable traveling around Inland Empire and San Diego ~50% of the time!
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What You'll Do
Team Leadership & Supervision
- Supervise, coach, and mentor Risk Adjustment Coding Specialists to ensure high-quality, compliant coding practices
- Serve as a resource for coders regarding ICD-10-CM, HCCs, CMS Risk Adjustment guidelines, and documentation standards
- Monitor individual and team productivity, accuracy, and quality metrics; provide ongoing feedback and corrective action as needed
- Utilize productivity, quality, and audit data to identify performance trends, coding gaps, and training opportunities
- Translate data insights into actionable feedback, performance improvement plans, and targeted education
- Assist with onboarding and training of new coding staff
Operational Support
- Support the Risk Adjustment Manager with day-to-day departmental operations, including workflow coordination, prioritization of audits, and issue resolution
- Assist in developing and maintaining standard operating procedures, workflows, and best practices
- Analyze Risk Adjustment data (e.g., recapture rates, audit findings, productivity, denial trends) to support departmental strategy and prioritization
- Collaborate with leadership to design and implement new or enhanced workflows for coders based on data, performance metrics, and operational needs
- Support reporting and dashboard development to track coding performance, quality outcomes, and Risk Adjustment impact
- Escalate operational, compliance, or performance issues to leadership as appropriate
Coding, Auditing & Compliance
- Review provider documentation and medical records to ensure all Medicare Advantage and Commercial Risk Adjustment requirements are met
- Perform and/or oversee retrospective and prospective medical record reviews to identify, assess, monitor, and document HCC coding opportunities
- Conduct coding quality audits to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation
- Analyze audit results to identify systemic coding or documentation trends and recommend process improvements
- Prepare audit analyses and provide feedback on noncompliance or documentation improvement opportunities
Provider & Staff Education
- Interact with physicians and provider office staff regarding coding, billing, and documentation policies and procedures
- Deliver education and training on Risk Adjustment and documentation improvement, both individually and in group settings
- Assist with the development of educational materials and presentations, including PowerPoint content
- Other duties as assigned
Qualifications
- Travel
- Reliable transportation and valid driver’s license
- Ability to travel up to 75% of the time within the designated markets, primarily Houston, with travel to Beaumont and San Antonio as needed.
- Certifications
- Certified Coding Specialist (CCS or CCS-P) OR Certified Professional Coder (CPC)
- Certified Risk Adjustment Coder (CRC) (not required but highly preferred)
- Experience
- Minimum of 4–5 years of medical coding experience, including Risk Adjustment and HCC coding
- Prior lead, senior, or supervisory experience
- Skills & Abilities
- Strong knowledge of Medicare Advantage Risk Adjustment and Hierarchical Condition Categories (HCC)
- Strong data analysis skills with the ability to interpret coding, audit, and performance metrics
- Ability to identify patterns and trends within Risk Adjustment data to inform decision-making and workflow design
- Experience using data to drive operational improvements and support Risk Adjustment initiatives
- Advanced Excel skills preferred (e.g., pivot tables, reporting, data analysis)
- Excellent verbal, written, and presentation skills
- Demonstrated ability to educate and train coding staff and provider office personnel
- Expert-level proficiency in Microsoft Word, Excel, Outlook, and PowerPoint
- Strong organizational, analytical, and problem-solving skills
You're great for the role if:
- Have deep expertise in Risk Adjustment and HCC coding
- Are data-driven and comfortable using metrics to guide decisions and improve outcomes
- Enjoy analyzing trends and patterns to enhance Risk Adjustment performance
- Have experience building or refining workflows that improve coder efficiency and accuracy
- Enjoy leading, mentoring, and developing coding professionals
- Thrive in a fast-paced, collaborative environment
- Are detail-oriented and committed to coding accuracy and compliance
- Are comfortable supporting management with operational and workflow needs
Environmental Job Requirements and Working Conditions
- Our organization follows a hybrid work structure where the expectation is to work both onsite and at home on a weekly basis. Up to 75% travel is required in designated market(s).
- The home office of this department is located at 600 City Parkway in Orange. This position will oversee the Inland Empire and San Diego regions.
- The total compensation target pay range for this role is $80,000 - $90,000 per year. The salary range represents our national target range for this role. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [email protected] to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
About
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient. Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Skills Required
- Certified Coding Specialist (CCS or CCS-P) OR Certified Professional Coder (CPC)
- Certified Risk Adjustment Coder (CRC)
- Minimum of 4-5 years of medical coding experience, including Risk Adjustment and HCC coding
- Prior lead, senior, or supervisory experience
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The Company
What We Do
Astrana Health is a physician-centric, technology-powered healthcare company that operates an integrated delivery platform. It enables providers to participate in value-based care arrangements, helping them deliver accessible, high-quality, and cost-effective care to patients. The company provides care coordination services to patients, primary care physicians, specialists, and health plans, leveraging proprietary technology to streamline operations and improve patient outcomes across local communities.
