Senior Risk Adjustment Coder

Job Description

Drive Accuracy. Influence Outcomes. Protect Revenue.

We are seeking a highly experienced Senior Risk Adjustment Coder to play a critical role in risk adjustment accuracy, audit readiness, provider education, and clinical documentation excellence.

Job Title:

Senior Risk Adjustment Coder

Location:

Newark, CA (Candidates must currently reside within approximately 45–65 miles of the Newark area due to onsite operational needs.)

Employment Type:

Full-Time (Direct Hire)

Salary Range:

$91,000 – $119,000 annually, based on experience, skills, and internal equity About the Role:

We are seeking a senior-level Risk Adjustment professional to support a leading healthcare organization focused on accurate HCC capture, audit readiness, documentation integrity, and provider engagement.

This role is highly operational and collaborative in nature and is not a traditional production-only coding position. The ideal candidate will bring strong expertise across Risk Adjustment workflows, including:

pre-visit reviews

concurrent reviews

retrospective audits

documentation validation

provider-facing education

CMS-compliant HCC coding practicesThis position works closely with clinicians, coding leadership, compliance teams, and operational stakeholders to improve documentation quality, RAF accuracy, and overall coding integrity. Key Responsibilities:

Perform Risk Adjustment coding and chart abstraction in alignment with CMS guidelines and Medicare Advantage Risk Adjustment models

Conduct pre-visit chart reviews to identify suspect conditions, coding gaps, and documentation opportunities prior to patient encounters

Perform concurrent and retrospective coding audits and validation reviews to ensure coding accuracy and compliance

Identify opportunities for HCC capture, recapture, and suspecting workflows

Review historical encounters, labs, and supporting clinical documentation to validate chronic condition capture

Ensure documentation supports CMS-compliant coding standards and M.E.A.T. criteria (Monitor, Evaluate, Assess, Treat)

Communicate documentation clarification opportunities and coding recommendations directly with providers and clinical teams

Support provider-facing clinical documentation improvement (CDI) initiatives and coding education efforts

Participate in provider onboarding, documentation education, and coding clarification discussions as needed

Collaborate with coding, compliance, operational, and revenue cycle teams to improve coding accuracy and audit readiness

Support documentation defensibility and compliance initiatives related to Risk Adjustment coding

Stay current with CMS regulations, ICD-10 guidelines, HCC model changes, and Risk Adjustment best practices Required Qualifications:

Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) required

5+ years of dedicated Risk Adjustment / HCC coding experience

Strong knowledge of Medicare Advantage and CMS Risk Adjustment models

Experience with:

pre-visit reviews

concurrent reviews

retrospective audits

documentation validation

suspecting workflows

Strong understanding of HCC capture, recapture, RAF impact, and coding compliance principles

Experience working directly with providers on documentation clarification and coding education

Strong audit and documentation review sophistication

Familiarity with EHR systems (Epic preferred) and coding/audit tools

Excellent analytical, communication, and collaboration skills

Ability to navigate provider conversations and documentation clarification discussions professionally What We’re Looking For:

We’re looking for a detail-oriented and operationally mature Risk Adjustment professional who can balance coding accuracy, provider collaboration, audit defensibility, and documentation integrity in a fast-paced healthcare environment.

Ideal candidates will demonstrate:

Strong provider-facing communication skills

Independent workflow ownership and problem-solving ability

Strong understanding of pre-visit and concurrent review workflows

Ability to identify documentation gaps and coding opportunities effectively

Compliance-focused coding judgment

Comfort working cross-functionally with clinicians and operational teams

Passion for improving documentation quality and patient risk capture Work Model & Schedule:

Primarily remote role with hybrid operational expectations

Candidates must be comfortable attending:

Quarterly in-person team meetings

Ad hoc onsite clinic visits and operational meetings as needed

Potential next-day onsite requests based on business or provider support needs

Strong preference for candidates within commuting distance to Newark, CA due to provider interaction and operational collaboration requirements

Monday–Friday schedule

Flexible start times between approximately 6:30 AM – 8:00 AM PST

Typical workday ends around 4:00 PM PS About Power Personnel:

Power Personnel is a trusted healthcare staffing and workforce solutions partner with a strong track record supporting leading health systems and organizations across California and nationwide.

With deep expertise across clinical, administrative, revenue cycle, and operational functions, we connect top healthcare talent with high-impact opportunities that drive quality care and operational excellence.

Our team is committed to a consultative, candidate-first approach — ensuring alignment not only with role requirements, but also long-term career goals.

Referral Bonus:

Refer a friend to and earn a $500 referral bonus!

(Referral must complete 20 shifts to qualify.)

Full-time