Risk Adjustment Documentation & Coding Educator

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