CenCal Health

Central Coast Salary Range: $31.17 - $45.20 Job Summary The Risk Adjustment Coder Specialist ensures accurate medical diagnosis data submission to CMS for CenCal Health Medicare Advantage D-SNP line of business. This role optimizes diagnosis documentation, identifies barriers to appropriate risk adjustment, oversees outsourced vendor coding for CMS compliance, and partners with provider outreach teams to educate providers on accurate and comprehensive medical coding. Duties & Responsibilities Perform reviews of records to identify, validate, and ensure accurate capture of diagnosis codes aligned with CMS-HCC, HHS-HCC, ICD-10-CM and applicable risk adjustment requirements. Oversee vendor coding activities, including monitoring work quality, reviewing vendor coded records, validating findings, resolving discrepancies, and providing feedback to vendors and internal leadership. Collaborate with provider groups and internal departments to resolve coding questions, clarify...

Risk Adjustment Coder Specialist Main Office - Santa Barbara, CA 93110 Start Date 10/02/2026 Overview Salary Range $31.17 - $45.20 Hourly Position Type Full Time Category Financial Analytics Description Central Coast Salary Range: $31.17 - $45.20 Job Summary The Risk Adjustment Coder Specialist ensures accurate medical diagnosis data submission to CMS for CenCal Health Medicare Advantage D-SNP line of business. This role optimizes diagnosis documentation, identifies barriers to appropriate risk adjustment, oversees outsourced vendor coding for CMS compliance, and partners with provider outreach teams to educate providers on accurate and comprehensive medical coding. Duties & Responsibilities Perform reviews of records to identify, validate, and ensure accurate capture of diagnosis codes aligned with CMS-HCC, HHS-HCC, ICD-10-CM and applicable risk adjustment requirements. Oversee vendor coding activities, including monitoring work quality, reviewing vendor...

Paycom - ATS is seeking a Risk Adjustment Coder Specialist to ensure accurate medical diagnosis data submission to CMS for CenCal Health Medicare Advantage D-SNP. You will optimize documentation, oversee vendor coding, and educate providers on risk adjustment standards. The role requires expertise in CMS risk models, ICD-10-CM guidelines, and strong collaboration with clinical and analytics teams to enhance risk adjustment outcomes. #J-18808-Ljbffr