What You’ll Do
- Build trusted working relationships with network practice coders, coding leaders, providers, regional clinical leaders, and operational partners to understand workflows, identify needs, and provide practical support.
- Conduct targeted prospective and retrospective medical record reviews across applicable risk adjustment and documentation workflows to evaluate coding accuracy, completeness, specificity, clinical support, annual reassessment.
- Deliver individual and group education sessions, primarily through virtual platforms, for providers, coding teams, and leadership on risk adjustment, HCC documentation, ICD-10-CM guidelines, clinical documentation requirements, compliant query practices, CMS expectations, and value-based care initiatives.
- Analyze coding performance indicators, error trends, documentation gaps, and coding patterns to identify high-risk clinical areas, provider opportunities, and targeted educational needs.
- Translate coding and documentation findings into prioritized coaching, remediation strategies, and scalable education programs.
- Support onboarding, office hours, case reviews, peer learning sessions, and individualized follow-up education as needed.
- Develop and maintain training materials, presentations, job aids, feedback tools, frequently asked questions, and educational resources. Support education and governance for point-of-care coding and documentation tools, reinforcing clinical validation, supporting documentation, and compliant use of prompts and suggestions.
- Partner with Network Engagement and Risk Adjustment leadership to scale consistent education across affiliated practices. Provide insights that inform peer-to-peer coaching for regional medical directors and other clinical leaders.
- Collaborate with Compliance, Legal, Coding Operations, Analytics, Informatics, and Product teams to ensure guidance and education are accurate, practical, consistent, and aligned with approved program scope.
- Ensure compliance with all regulatory standards for risk adjustment, including CMS guidelines, ICD-10-CM coding conventions, documentation integrity requirements, and applicable federal and state regulations.
- Travel periodically to meet network partners, support onsite education, and facilitate business priorities as needed.
Minimum Qualifications
- Active Certified Risk Adjustment Coder (CRC) certification required.
- 6+ years combined related education, experience, or certification, including experience in risk adjustment coding, clinical documentation improvement, provider education, medical record review, coding compliance, or related healthcare discipline.
- Demonstrated experience translating coding and documentation findings into targeted education, coaching, and remediation plans.
- Extensive knowledge of coding and documentation standards established by the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA), as well as Medicare Advantage risk adjustment, CKCC, HCC models, ICD-10-CM coding guidelines, and clinical documentation requirements.
- Strong analytical skills with the ability to identify trends, evaluate root causes, and communicate findings effectively to diverse audiences.
- Exceptional presentation, facilitation, written, and verbal communication skills.
- Ability to develop strong relationships with providers, coding teams, operational leaders, and external partners.
- Ability to work independently, manage multiple priorities, and thrive in a fast-paced, matrixed environment.
- Ability to travel and be onsite to meet business needs, with reliable transportation and an active driver’s license as applicable.
- Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms.
Preferred Qualifications
- Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), or another relevant AHIMA or AAPC credential.
- Experience supporting affiliated practices, delegated provider groups, accountable care organizations, managed care, population health, or other value-based care programs.
- Experience with CKCC, P4P, Medicare Advantage, ESRD, ACA, or other risk-adjusted programs.
- Experience with documentation integrity programs, prospective or retrospective chart review, or remediation standards.
- Experience supporting coding and documentation tools, EHR workflows, or point-of-care technologies.
- Associate or bachelor’s degree in health information management, healthcare administration, nursing, public health, or related field.
- Experience educating or coaching network practice coders, coding teams, providers, or other clinical and operational stakeholders.
About You
You are an experienced risk adjustment and coding professional who can effectively balance detailed chart review, clinical documentation improvement, and provider education.
You make complex coding and documentation concepts understandable and actionable for busy providers and coding teams.
You combine strong technical expertise with relationship-building skills and a collaborative approach.
You are comfortable providing direct, constructive feedback while maintaining trust and a compliance-focused mindset.
You are highly organized, detail-oriented, and skilled at identifying patterns across providers, practices, coding teams, and markets.
You are motivated by improving documentation integrity, coding accuracy, provider engagement, and value-based care outcomes through scalable education and coaching programs.
Expected Impact
Improved coding accuracy and documentation integrity across network practices.
Stronger provider and operational leadership understanding of risk adjustment requirements and chart review expectations.
More consistent, compliant use of documentation and coding workflows.
Earlier identification of unsupported, inconsistent, or incomplete coding patterns.
Actionable feedback loops that use audit findings to drive targeted education for coders, coding leaders, providers, network teams, and clinical leadership.
Improved network audit readiness and reduced documentation-related compliance risk.
Scalable education and audit support for Strive’s network, CKCC, P4P, and broader value-based care programs.
Annual Salary Range: $74,000 - $90,000
Final compensation will be determined based on location, experience, and qualifications.
If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talentacquisition@strivehealth.com.
We do not accept unsolicited resumes from outside recruiters/placement agencies. Strive Health will not pay fees associated with resumes presented through unsolicited means.
