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 health for communities across the country.ResponsibilitiesThe day-to-day responsibilities of the Risk Adjustment Coding Senior Manager will include but are not limited to the following:Lead the Gather Disease Detection and Treatment (DDAT) program to ensure screening, documentation, and coding practices are aligned with CMS and organizational goalsLead 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 codingParticipate in chart reviews as neededCollaborate with providers and clinic staff regularly to provide observations and trends related to documentation and coding practices in the centerProvide 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 practicesSupport coding compliance audits as necessarySupport Revenue Cycle team with claims corrections and denials as neededMaintain current knowledge of medical coding and HCC risk adjustment guidelinesQualificationsWhat are the requirements for this position?4+ years working as a physician coder (including at least 2 years supporting risk adjustment coding)Deep understanding of Medicare Risk Adjustment and compliance requirementsRisk Adjustment Coder credential (e.g., AAPC CRC, or similar)Ability to work for any employer in the United StatesWhat are the skills or experience?Process improvementExperience working with electronic health records (EHR) systemsExperience in a healthcare setting with a focus on quality improvementExperience working with data analytics and reporting toolsWhat are the traits and characteristics of the ideal candidate most likely to succeed?Strong interpersonal skills; in particular a track record of building effective working relationships with providersDetail-oriented – demonstrates exceptional attention to detail in coding and documentation reviewProactive – actively identifies and addresses potential coding and compliance issuesAdaptable – able to effectively manage multiple tasks and adapt to changes in regulations and guidelinesWhy should I join Gather Health?We are a mission-based organization that is passionate about changing the way seniors experience primary careOur business model is unique and on the cutting-edge of the primary care industryOur 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 colleaguesWe are intentionally building a strong company culture and providing a compassionate and joyful work environmentThe organization was conceptualized, founded, and launched by experienced co-founders with a track record of success in the healthcare spaceWe offer competitive pay and benefits for our Full-Time colleagues, including:Generous PTOEleven Paid HolidaysMedical insurance coverage (health, dental, vision) with no waiting period for enrollmentShort and Long-Term insurance at no cost to youBasic life insurance coverage at no cost to you401K plan with 100% employer match, up to 4% of your salarySupplemental benefits availableGather Health is an Equal Opportunity Employer. All employment decisions are made without regard to race, creed, color, ancestry, status, veteran status, or expression, genetic information, marital status, citizenship status, or any other basis as protected by federal, state, or local law. #J-18808-Ljbffr

Created: 2025-09-28