Senior Manager of Risk Adjustment Coding

OverviewGather Health delivers Social Primary Care to older adults. Through our unique and differentiated care model and proprietary technology, Gather Health’s solution drives substantial care outcomes by addressing the whole person needs of their target demographic: dual eligible populations, the fastest growing government segment.To address the needs of these clinically and socially complex patients, Gather Health’s Social Primary Care solution is comprehensive and wholistic in nature, encompassing care and community within the four walls of Gather Health Centers and in the homes of its patients.This innovative approach leads to dramatically better outcomes for our patients and creates a more sustainable and equitable model for the healthcare system. We are looking for talented professionals to help us build the platform, scale our operations, and create generational health for communities across the country. Responsibilities Lead the Gather Disease Detection and Treatment (DDAT) program to ensure screening, documentation, and coding practices are aligned with CMS and organizational goals Lead Gather coding team to ensure chart reviews (pre, concurrent, and post) are completed to ensure the most complete and accurate representation of patients’ health by identifying opportunities to improve accuracy of diagnoses documentation and coding Participate in chart reviews as needed Collaborate with providers and clinic staff regularly to provide observations and trends related to documentation and coding practices in the center Provide education to providers and staff on topics related to compliant and accurate documentation and coding (e.g., CMS Medicare Risk Adjustment procedures and regulations, documentation guidelines, etc.) Audit charts and consult providers on opportunities to improve documentation and coding practices Support coding compliance audits as necessary Support Revenue Cycle team with claims corrections and denials as needed Maintain current knowledge of medical coding and HCC risk adjustment guidelines Qualifications 4+ years working as a physician coder (including at least 2 years supporting risk adjustment coding) Deep understanding of Medicare Risk Adjustment and compliance requirements Risk Adjustment Coder credential (e.g., AAPC CRC, or similar) Ability to work for any employer in the United States Preferred skills and experience Process improvement Experience working with electronic health records (EHR) systems Experience in a healthcare setting with a focus on quality improvement Experience working with data analytics and reporting tools Traits and characteristics Strong interpersonal skills; in particular a track record of building effective working relationships with providers Detail-oriented – demonstrates exceptional attention to detail in coding and documentation review Proactive – actively identifies and addresses potential coding and compliance issues Adaptable – able to effectively manage multiple tasks and adapt to changes in regulations and guidelines Why join Gather Health We are a mission-based organization that is passionate about changing the way seniors experience primary care Our business model is unique and on the cutting-edge of the primary care industry Our leadership team is comprised of experienced individuals who are committed to creating not only the best patient experience, but also an amazing employee experience for our colleagues We are intentionally building a strong company culture and providing a compassionate and joyful work environment The organization was conceptualized, founded, and launched by experienced co-founders with a track record of success in the healthcare space Benefits Generous PTO Eleven Paid Holidays Medical insurance coverage (health, dental, vision) with no waiting period for enrollment Short and Long-Term disability insurance at no cost to you Basic life insurance coverage at no cost to you 401K plan with 100% employer match, up to 4% of your salary Supplemental benefits available Gather Health is an Equal Opportunity Employer. All employment decisions are made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status, or any other basis as protected by federal, state, or local law. #J-18808-Ljbffr

Created: 2025-09-24