Habitat Health is looking for a Certified Risk Adjustment Coder who is passionate about supporting accurate and compliant documentation for our PACE participants. We build engaged, fulfilled care teams to deliver personalized care. This role requires a self-starter who thrives in an independent, remote environment.
What You'll Do
- Review participant medical records and provider documentation to identify, validate, and code risk-adjustable diagnoses in accordance with CMS-HCC v24 and v28 guidelines.
- Ensure complete, accurate, and compliant ICD-10-CM coding with a primary focus on concurrent and retrospective reviews (with flexibility for pre-visit planning as needed).
- Draft and submit compliant provider queries to clarify documentation and support accurate coding.
- Track and follow through on open queries—engaging with providers, monitoring responses, and closing them out appropriately.
- Apply strong critical thinking skills to resolve complex documentation and coding scenarios.
- Maintain clear, professional communication with providers and internal teams to support documentation completeness.
- Stay current with CMS, OIG, and industry regulations related to risk adjustment and coding compliance.
What We're Looking For
- Active CRC (Certified Risk Adjustment Coder) certification required.
- Minimum of 1 year of experience in risk adjustment coding.
- In-depth knowledge of ICD-10-CM and CMS-HCC models v24 and v28.
- Demonstrated ability to work independently, stay organized, and follow through on tasks with minimal oversight.
- Strong written and verbal communication skills, with the ability to engage providers in a professional and solutions-oriented manner.
- High attention to detail and ability to critically analyze clinical documentation.
Work Mode
This is a fully remote position.
