Amada Health is seeking a motivated coder with Medicare Advantage Risk Adjustment (HCC) experience to join its Quality & Risk Adjustment team. The role focuses on accurate ICD-10-CM diagnosis coding, HCC capture, chart review, and provider education to support compliant documentation and optimal risk adjustment reporting.
This position supports Medicare Advantage risk adjustment initiatives through retrospective and prospective chart review, coding audits, and collaboration with provider groups and clinical staff. The role is hybrid and based in Central Valley and Northern California, with work location in Fresno, CA.
Required
- Certified RAF Coder; CRC required within 6 months
- 1–2 years of HCC coding experience, including guidelines and MEAT criteria
- Strong knowledge of ICD-10-CM coding guidelines
- Strong understanding of the Medicare Advantage risk adjustment model
- Experience with prospective and retrospective chart review
- Familiarity with Annual Wellness Visit documentation requirements
- Maintain coding certification
- Maintain coding accuracy of at least 95%
- Meet Quality Department productivity standards
Preferred
- Certified Professional Coder (CPC)
- Experience with IPA, Medical Group, or Health Plan risk adjustment programs
- Knowledge of RADV audit standards
- Experience using EHR and risk adjustment analytics tools
- Experience with HEDIS and 5 Star gap closure
- HHS-HCC coding experience
Skills
- Proficient in Excel
- Strong attention to detail
- Excellent communication skills
- Strong organization and time management
- Ability to manage multiple priorities and deadlines
- Ability to collaborate with colleagues, providers, and clinical staff
- 401(k)
- Dental insurance
- Employee assistance program
- Health insurance
- Health savings account
- Paid time off
- Parental leave
- Referral program
- Vision insurance
Location
Fresno, California, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$56,160 - $72,800
Remote work allowed
No
Posted
1 month ago