Talent.com
Health Risk Adjustment Coder

Health Risk Adjustment Coder

Blue Zones HealthSan Bernardino, CA, US
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

At Blue Zones Health we are redefining what it means to live a vibrant and healthy lifestyle. Inspired by long-living cultures around the world, we strive to empower people to make simple and sustainable lifestyle changes that lead to longer, better and more fulfilling lives. If you are ready to help transform well-being and be a pivotal part of our team, we want to meet with you!

Position Summary

The Health Risk Adjustment Coder plays a vital role on the Blue Zones Health Optimization Team. This individual owns risk adjustment strategy implementation, partner relationships, compliance, and quality performance initiatives related to Medicare Risk Adjustment (MRA). The role focuses on the development and oversight of data-driven programs that support accurate coding, provider engagement, performance improvement, and regulatory compliance.

This is a remote position with local travel required 2–3 times per week to provider practices across the Inland Empire region.

The compensation range for this role is $70,000 - $90,000 annually depending on experience.

Key Responsibilities

  • Serve as the subject matter expert (SME) and lead initiatives across prospective, retrospective, and concurrent MRA strategies.
  • Monitor risk adjustment coding compliance and performance across the organization.
  • Guide provider documentation, chart review accuracy, and coding integrity to ensure appropriate HCC recapture.
  • Conduct internal education for clinical staff and providers on accurate coding practices and clinical documentation improvement.
  • Lead cross-functional collaboration with Finance, Analytics, and the Vitality team to identify coding improvement opportunities and drive data-informed strategies.
  • Partner with vendors and payers to oversee coding performance, program integrity, and service level adherence.
  • Drive completion of key KPIs, including risk score accuracy, coding quality, and annual wellness visit (AWV) completion rates.
  • Support operational leaders and provider engagement teams with workflow integration and training for value-based risk and quality initiatives.
  • Support tailored campaign strategies for risk and quality performance improvement based on local market needs and provider group trends.
  • Ensure all activities meet federal, state, and partner compliance requirements.
  • Provide regular updates and progress reports to senior leadership and key stakeholders.

Required Education and Experience

Licensure & Certification (one or more required) :

  • Certified Professional Coder (CPC) – AAPC
  • Certified Risk Adjustment Coder (CRC) – AAPC
  • Certified Coding Specialist for Providers (CCS-P) – AHIMA
  • Registered Health Information Technician (RHIT) – AHIMA

    • Experience

  • Minimum 2 years in medical operations, specifically within value-based care and risk adjustment coding.
  • Demonstrated knowledge of Medicare Advantage, RAF scores, and risk score documentation.
  • Prior experience educating providers on correct coding and care gap closure.
  • Strong project management and performance tracking skills.

    • Skills and Competencies

  • Proficient in MS Office Suite (Excel, Word, PowerPoint).
  • Strong analytical thinking, public speaking, and written communication skills.
  • Ability to synthesize data and translate trends into actionable strategies.
  • Skilled at building relationships and working cross-functionally.
  • Experience presenting coding performance trends to physician groups or leadership.
  • Self-directed, detail-oriented, and able to manage multiple priorities effectively.

    • Working Conditions

  • Remote work with local travel to clinics in the Inland Empire 2–3 days per week.
  • Normal office working conditions with flexibility in scheduling.
  • Must have reliable transportation and the ability to travel within the assigned region.

    • For more information about Blue Zones Health , check us out at www.bluezoneshealth.com.

    Blue Zones Health does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity or expression, age, disability, veteran status, or any other protected status under applicable law.

    serp_jobs.job_alerts.create_a_job

    Risk Adjustment Coder • San Bernardino, CA, US