Strive Health
RiskAdjustmentCoder
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Risk Adjustment Coder at Strive Health. Skills: Risk Adjustment Coding, ICD-10-CM, CPT, HCC Coding. Reviewing risk adjustment visits for appropriate clinical documentation support.. Supporting the growth and improvement of Strive’s risk adjustment capabilities.”
What You'll Achieve.
improve overall health outcomes for patients and continuity of care.; accurate coding and documentation; high quality and accurate risk adjustment coding; drive capture of correct Risk Adjustment coding; coding productivity and 95% accuracy
Industry & Context.
clinical assessment and critical thinking skills.; customer focused approach in dealing with conflict and resolution of problems.
Ability to travel and be onsite to meet business needs., Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms.
What They're Looking For.
Must Have
Active, approved CRC (Certified Risk Adjustment Coder) or CPC (Certified Professional Coder) License. From AAPC or AHIMA., 5+ years combined of related education, coding/auditing experience, or certification., Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms., Ability to travel and be onsite to meet business needs.
Nice to Have
5+ year’s experience using ICD-10-CM, 2+years’ experience with risk adjustment coding and training geared toward physicians., Expert in coding and documentation guidelines, knows how to develop relationships with clinicians, effective, communicator., presentation experience in the following areas: ICD-10-CM, CPT and HCPCS., Extensive knowledge of documentation and coding guidelines established by the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) for assignment of diagnostic and procedural codes., Knowledge of Federal laws and regulations, including NCDs and LCDs affecting risk adjustment documentation and coding compliance., MS Office Suite, Electronic Medical Records, Encoder, and other software programs and internet-based applications.
What You'll Do.
Reviewing risk adjustment visits for appropriate clinical documentation support.
Supporting the growth and improvement of Strive’s risk adjustment capabilities.
Ensuring technical aspects of diagnostic and procedure coding follow CMS
third party payers and other regulatory agencies.
Reviewing assigned provider's documentation and coding from end to end
including proper application of ICD-10 codes
CPT and CPT II codes.
Educating assigned providers on CMS
AMA and Strive documentation and ICD-10-CM coding guidelines
Performing provider queries and addendum requests based on CMA
AMA documentation and coding guidelines.
Assisting in special coding audits and coding projects as necessary.
Providing ongoing feedback to the clinical management team regarding coding and documentation trends to ensure accurate coding and documentation to improve overall health outcomes for patients and continuity of care.
Delivering value to Strive and its beneficiaries enrolled in Risk Adjusted government programs (MA
using skills including but not limited to: HCC (Hierarchical Condition Category) Coding
clinical terminology and anatomy/physiology
CMS coding guidelines
and review of CPT and CPT II codes as applicable.
Works closely with physicians
and compliance partners at enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding.
Supports all Strive risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC disease categories.
Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement
and identifying process improvements.
Performs HCC coding on projects for MA
Ability to quickly flex between coding projects
including retro and prospective
Works independently in various coding applications and electronic medical record systems to support departmental goals.
Consistently meet coding productivity and 95% accuracy and any additional requirements as set forth by the Coding Manager.
How You'll Work.
Team & Collaboration
Works closely with physicians, team members, quality, and compliance partners at enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding.; Ability to work in a remote team environment while also being a individual contributor.
Communication Scope
Excellent verbal and written communication skills.; effective, communicator.
Full Job Description
How You’ll Make An Impact At Strive Health, patients come first. We’re on a mission to transform chronic conditions by identifying risk earlier, coordinating thoughtful care, and supporting people through every stage of their health journey. Our work reduces emergency visits, improves outcomes, and helps patients live fuller lives. You’ll work alongside passionate Strivers who care deeply about making an impact, show up for one another as One Team, and find ways to elevate the everyday. If you’re looking for meaningful work where your contributions truly matter, you’ll feel right at home at Strive! Benefits & Perks Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home visits. Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts. Financial & Retirement Support – Competitive compensation with a performance-based bonus program, 401k with employer match, and financial wellness resources. Time Off & Leave – Paid holidays, vacation time, sick time, and paid birthgiving, bonding, sabbatical, and living donor leaves. Wellness & Growth – Family forming services through Maven Maternity at no cost and physical wellness perks, mental health support, and an annual professional development stipend. To learn more about our offerings, click here. What You’ll Do The Coder, Risk Adjustment Coding is responsible for supporting the Strive operational and clinical team and partner Nephrologists by reviewing risk adjustment visits for appropriate clinical documentation support. This role is responsible for supporting the growth and improvement of Strive’s risk adjustment capabilities. The coder will ensure technical aspects of diagnostic and procedure coding follow CMS, NCQA, third party payers and other regulatory agencies. They will review assigned provider's documentation and coding f
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