Manager, Coding and Risk Adjustment

Job not on LinkedIn

🕒 Yesterday

🌵 Arizona – Remote

🌵 Arizona – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🎲 Risk

👻 Ghost score 12%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Adobe Population Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2018

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Adobe Population Health is a care management company that provides integrated population health and whole-person care management solutions for public and commercial health plans. The organization partners with Medicaid, Medicare, and ACA Marketplace plans to deliver proactive case management, in‑home support, and technology-enabled services (including an app that identifies social determinants of health barriers and connects members to local resources). Adobe Population Health also expands clinical offerings through acquisitions (e. g. , Eventa for respiratory care) and reports outcomes such as reduced ER use, lower claim costs, and high HRA completion rates.

📋 Description

• Lead, mentor, and develop a team of Medical Risk Coders and Chart Preparation staff • Conduct performance evaluations, coaching sessions, and ongoing staff development activities • Assist with recruitment, onboarding, training, and retention of coding team members • Establish productivity, quality, and performance expectations for coding staff • Oversee daily coding operations for accuracy, productivity, and compliance • Review medical records and documentation to identify appropriate ICD-10-CM diagnosis codes and CMS-HCC opportunities • Monitor HCC recapture initiatives and improve RAF scores and risk adjustment outcomes • Maintain departmental coding accuracy standards of 95% or greater • Conduct coding audits and quality reviews; develop corrective action plans • Monitor compliance with CMS, Medicare, Medicaid, HIPAA, and organizational policies • Support internal, external, health plan, and regulatory audit readiness • Educate and train providers on coding accuracy, risk adjustment, HCC documentation, HEDIS, and STARS guidelines • Review provider documentation and develop training materials and coding reference tools • Partner with clinical leadership to improve provider documentation and coding performance • Provide real-time coding and documentation support to providers and clinical teams • Develop and monitor reports on coding accuracy, audit performance, HCC recapture, provider performance, productivity, and quality outcomes • Analyze coding trends and implement data-driven operational and financial improvements • Develop workflow improvements and support new coding processes, technologies, and system enhancements • Collaborate with cross-functional departments and drive scalable infrastructure improvements • Maintain confidentiality of Protected Health Information (PHI) • Participate in quality improvement initiatives and perform additional duties as assigned

🎯 Requirements

• 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 • Strong knowledge of CMS-HCC Risk Adjustment Methodology • Strong knowledge of Medicare Advantage • Strong knowledge of Medicaid Risk Adjustment • Strong knowledge of HEDIS • Strong knowledge of STARS • Strong knowledge of RAF Scoring • Strong knowledge of Provider Documentation Improvement (PDI) • Strong knowledge of 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 • High School Diploma or GED required • Active Certified Risk Adjustment Coder (CRC) credential required • Bachelor's degree in healthcare administration, health information management, business administration, nursing, or a related field preferred • CPC, CCS, RHIT, RHIA, or additional coding certification preferred • Experience with Salesforce or other CRM platforms preferred • Must be able to physically perform the essential duties, including lifting 30 lbs., transporting materials, stooping, kneeling, crouching, reaching, use of hands, balancing, walking, standing, talking, hearing, and typing

🏖️ Benefits

• Paid Orientation and Training • Medical, Dental, Vision, and Life insurance • 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 • Fully remote position