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 practices
This 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
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 referrals@powerpersonnel.com and earn a $500 referral bonus!
(Referral must complete 20 shifts to qualify.)
Explore exciting job opportunities in and around Newark, California! Situated in the heart of the San Francisco Bay Area, Newark offers an unbeatable blend of career advancement and quality of life. With easy access to Silicon Valley and major tech companies, as well as the cultural delights of nearby Berkeley and Oakland, this area is a magnet for innovative professionals. Enjoy the stunning views from Mission Peak Regional Preserve, indulge in diverse cuisines along the Niles Canyon Railway, catch a show at the Fremont Center for the Arts, or cheer on the San Jose Earthquakes soccer team at Avaya Stadium. Discover why Newark, CA is the perfect place to grow your career and explore new horizons!
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