About this role
The Certified Risk Coder plays a critical role in supporting Astrana Health's value-based care and risk adjustment initiatives by ensuring the accurate capture and validation of diagnoses through comprehensive medical record review and coding analysis. This position partners closely with providers and clinical teams to improve documentation quality, coding accuracy, and compliance with CMS risk adjustment guidelines. The ideal candidate brings strong coding expertise, a passion for provider education, and a commitment to enhancing organizational performance through accurate risk capture, regulatory compliance, and continuous process improvement. Our Values: Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team Review medical records and provider documentation to ensure accurate capture of risk-adjusting diagnoses and compliance with CMS guidelines Perform retrospective and prospective HCC coding reviews to identify documentation and coding opportunities Validate ICD-10-CM codes and ensure diagnoses are clinically supported and accurately reported Conduct coding audits and quality reviews to maintain documentation integrity and regulatory compliance Partner with providers and clinical teams to improve documentation accuracy and risk adjustment performance Deliver one-on-one and group education sessions on coding, documentation, and risk adjustment best practices Communicate audit findings, coding trends, and improvement opportunities to providers and leadership Stay current on ICD-10-CM, HCC, CMS Risk Adjustment, and payer-specific coding requirements Support process improvement initiatives that enhance coding accuracy, compliance, and operational efficiency Serve as a coding resource and mentor to team members, supporting training and knowledge sharing across the organization Participate in special projects, departmental initiatives, and high-volume work efforts as assigned