You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a Risk Adjustment Coder to act as the clinical coding subject matter expert and lead coding resource across the organization. The primary responsibilities include ensuring accurate coding, appropriate reimbursement, and supporting data-driven insights that aid the broader organizational goals of the health plan. The candidate will work closely with internal and external partners to optimize risk adjustment performance and provide education to providers on clinical coding standards.

Responsibilities / Job Duties

• Act as the clinical coding subject matter expert and lead coding resource across the organization.
• Provide education to providers on clinical coding standards.
• Ensure accurate coding, appropriate reimbursement, and data-driven insights support organizational goals.
• Collaborate to optimize risk adjustment performance in Medi-Cal programs.
• Explain policies and procedures related to clinical coding.
• Accurately assign clinical codes and make final coding decisions.
• Conduct research, identify issues, make recommendations, and present findings clearly.
• Organize work, manage multiple tasks, establish priorities, and meet deadlines.
• Interpret and apply policies, standards, and guidelines.
• Facilitate meetings, develop training materials, and conduct trainings.
• Communicate effectively with stakeholders at all levels.

Minimum Education and Experience Qualification Requirements

Education

• Bachelor’s degree in Health Care, Business, Nursing, or a related field, or an equivalent combination of education and experience. An Associate’s degree with an additional 2 years of experience may substitute for the Bachelor’s degree.

Qualifications

• Certification as a Certified Coding Specialist (CCS) issued by the American Health Information Management Association.
• Certified Risk Adjustment Coder (CRC) issued by the American Academy of Professional Coders.
• 3+ years of clinical experience and 8 years of risk adjustment coding experience including provider education responsibilities.
• Medicaid experience.

Skills

• Knowledge of ICD-10, CPT, and HCPCS coding systems.
• Understanding of CMS Hierarchical Condition Categories (HCC) Risk Adjustment program.
• Proficiency in Electronic Medical Record (EMR) coding standards.
• Experience with Medicare and Medi-Cal coding policies.
• Project management, training development, and leadership skills.

Schedule / Shift

M-F business hours

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients