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Medicare Risk Adjustment Specialist I

Remote, USA Full-time Posted 2025-04-19

About On Belay Health Solutions

On Belay Health Solutions is a Massachusetts-based physician-led managed services organization (MSO) devoted to supporting independent primary care physicians. On Belay provides enhanced Medicare value-based contracts that empower physicians with the resources necessary to invest in innovative care models and population health management tools. This allows physicians to practice medicine and positively impact the health of their communities in the way they have always dreamed.

About the role
?? On Belay is seeking a motivated, passionate Risk Adjustment Specialist to enable this vision of care for our Medicare populations. This is a Full-Time role with expectation for 40 hours per week. We look forward to meeting interested applicants and mutually assessing fit in joining On Belay on our important mission to transform healthcare!

What you'll do
?? Responsible for the chart review and ICD-10 diagnosis coding of risk adjustment eligible members
?? Review of medical records for accuracy of ICD-10 diagnosis codes
?? Review of accurate capture of medical severity of any applicable illness(es)
?? Develop feedback loop with On Belay??s Head of Risk Adjustment Coding and physician offices On Belay supports, including but not limited to: o Identification of quality improvement opportunities in individual physician coding
?? Any other related duties assigned at manager??s discretion
?? Perform other duties as assigned

Qualifications
?? High school diploma or GED required. Associates degree preferred.
?? Active coding certificate required. AAPC or AHIMA coding certification preferred.
?? Required: CRC (Certified Risk Adjustment Coder) and one of the following
?? * CCS (Certified Coding Specialist),
?? CCS-P (Certified Coding Specialist- Physician based)
?? or CPC (Certified Professional Coder)
?? Minimum of two (4) years' experience working as a certified coder required. Two (2) or more years?? experience in a primary care setting highly preferred.
?? Knowledge of medical terminology and medical chart review required. Two (2) or more years?? experience of hierarchical condition categories (HCC)
?? Knowledge of ICD-10-CM Official Guidelines for Coding and Reporting
?? Knowledge of AHA Coding Clinic and authoritative coding resources
?? Knowledge of Microsoft Office suite, primarily Excel
?? Strong time management skills required
?? Ability to navigate within various EMRs (Electronic Medical Records)
?? Strong interpersonal, communication (verbal, non-verbal and listening) skills
?? Ability to remain productive under time constraints and meet deadlines critical to the business

Benefits
?? Benefits including Health & Dental reimbursement
?? Great culture with a strong sense of mission and community
?? Generous PTO Accural
?? Eleven (11) Paid Holidays
?? 401K Savings Plan
?? Advancement opportunities & professional skills training
?? Remote work
?? and more!

Compensation
?? We offer a competitive base salary ranging from $30 to $32 per hour annually, depending on experience.

Come join us on the journey to better and more affordable healthcare!

We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.

The pay range for this role is:
30 - 32 USD per hour(United States)

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