Coding, Revenue Integrity Specialist

Astrana Health

. Conduct prospective and retrospective chart audits for coding accuracy, documentation integrity, and regulatory compliance .

Posted 10/26/2026full-timeLas Vegas • Nevada • United StatesMid-LevelSenior💰 $25 - $31 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical coding, including ICD-10-CM, CPT, and HCPCS, while ensuring compliance with regulatory standards and optimizing revenue cycle performance. Proficient in conducting audits, providing education, and identifying documentation opportunities to enhance coding accuracy and integrity.

Highest-signal resume keywords

ICD-10-CM CodingCPT CodingHCPCS CodingCoding AuditsCertified Professional Coder (CPC)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical CodingBillingDocumentation StandardsRisk AdjustmentHCC CodingCompliance RequirementsAnalytical SkillsOrganizational SkillsProblem-Solving SkillsAttention to Detail

Soft Skills

CollaborationEducationFeedback

Tools & Technologies

EHR PlatformsMicrosoft Office SuiteEClinicalWorks

Certifications & Qualifications

Certified Professional Coder (CPC)Certified Coding Specialist (CCS)Certified Coding Specialist - Physician (CCS-P)Certified Risk Adjustment Coder (CRC)Certified Professional Medical Auditor (CPMA)Certified Professional Biller (CPB)Certified Medical Reimbursement Specialist (CMRS)

Industry Keywords

Revenue Cycle ManagementMedicareMedicaid Managed CareCommercial Payer ProgramsCMS ComplianceHIPAA Compliance

About the role

Key responsibilities & impact

Conduct prospective and retrospective chart audits for coding accuracy, documentation integrity, and regulatory compliance
Assign ICD-10-CM, CPT, HCPCS, and modifier codes based on provider documentation and coding guidelines
Validate HCC and Risk Adjustment diagnoses and identify documentation opportunities for accurate risk capture
Identify coding, documentation, and compliance gaps and provide actionable feedback
Perform coding audits, track findings and trends, and support corrective actions
Deliver provider and staff education on documentation standards, coding requirements, compliance guidelines, and risk adjustment
Support clean claim submission, denial prevention, revenue optimization, and resolution of coding-related billing issues
Collaborate with Revenue Cycle, Quality, Clinical Operations, and provider teams
Assist with audit readiness and maintain compliance with CMS, payer, HIPAA, and organizational requirements
Contribute to process improvement initiatives that strengthen coding quality, reimbursement accuracy, and revenue cycle performance

Requirements

What you’ll need

High school diploma or equivalent required
At least 3–5 years of experience in medical coding, billing, auditing, revenue cycle management, or related healthcare operations
Strong knowledge of ICD-10-CM, CPT, HCPCS, modifier usage, medical terminology, and documentation standards
Experience supporting Medicare, Medicare Advantage, Medicaid Managed Care, and Commercial payer programs preferred
Knowledge of risk adjustment, HCC coding, provider documentation improvement, and compliance requirements
Experience conducting coding audits and providing provider education and feedback
Strong analytical, organizational, and problem-solving skills with exceptional attention to detail
Proficiency with EHR platforms and Microsoft Office Suite; experience with eClinicalWorks preferred
Ability to manage multiple priorities while working independently in a remote environment
Certified Professional Coder (CPC) through AAPC OR Certified Coding Specialist (CCS or CCS-P) through AHIMA required
Certified Risk Adjustment Coder (CRC), Certified Professional Medical Auditor (CPMA), Certified Professional Biller (CPB), or Certified Medical Reimbursement Specialist (CMRS) preferred

Benefits

Comp & perks

Remote position supporting Astrana Health operations
Required onsite attendance for quarterly meetings, provider education sessions, trainings, and other operational activities as needed
Secure and HIPAA-compliant home office work environment
Target compensation of $25.00–$31.00 per hour, varying based on experience, certifications, education, skills, internal equity, and business needs