Risk Adjustment Coder

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 from end to end, including proper application of ICD-10 codes, CPT and CPT II codes. The coder shall educate assigned providers on CMS, AMA and Strive documentation and ICD-10-CM coding guidelines, as necessary. This role will perform provider queries and addendum requests based on CMA, AMA documentation and coding guidelines. This individual will assist in special coding audits and coding projects as necessary and provide 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. This role will report to the Manager, Risk Adjustment. The Day to Day Delivers value to Strive and its beneficiaries enrolled in Risk Adjusted government programs (MA, ACO, ACA, CKCC), using skills including but not limited to: HCC (Hierarchical Condition Category) Coding, medical coding, clinical terminology and anatomy/physiology, CMS coding guidelines, RADV Audits, and review of CPT and CPT II codes as applicable. 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. 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, provider education, analyzing reports, and identifying process improvements. Performs HCC coding on projects for MA, ACA, and ESRD. Ability to quickly flex between coding projects, including retro and prospective, with different MA, ESRD, and ACA HCC Models. Works independently in various coding applications and electronic medical record systems to support departmental goals. Shall consistently meet coding productivity and 95% accuracy and any additional req