job description
Join Shearwater Health as a Remote Risk Adjustment Coding Team Lead and take the helm of a high-performing team dedicated to ensuring accuracy, compliance, and efficiency in healthcare coding. In this pivotal role, you will oversee a group of skilled coding professionals, driving operational excellence while meeting critical service level agreements (SLAs) and project deadlines.
Based in the vibrant and culturally rich regions of Bali, Indonesia (including Canggu, Ubud, Denpasar, and more), this 100% remote position offers the perfect blend of professional growth and work-life balance. Your leadership will directly impact the quality of risk adjustment coding, ensuring our clients receive precise, audit-ready documentation that supports optimal reimbursement and regulatory compliance.
If you are a results-driven leader with a passion for healthcare coding and team development, this is your opportunity to make a meaningful difference in a dynamic, fast-paced environment.
Responsibility
- Lead, mentor, and manage a team of Risk Adjustment Coders to ensure accurate and timely coding in compliance with industry standards (e.g., ICD-10, HCC).
- Monitor team performance against SLAs, productivity metrics, and quality benchmarks, implementing corrective actions as needed.
- Collaborate with cross-functional teams (e.g., Clinical, Operations, Compliance) to streamline workflows and improve coding efficiency.
- Conduct regular audits and reviews of coded charts to ensure accuracy, completeness, and adherence to regulatory guidelines.
- Develop and deliver training programs to enhance team skills in risk adjustment methodologies, documentation best practices, and coding updates.
- Identify process improvements and leverage technology (e.g., EHR systems, coding software) to optimize team productivity.
- Serve as the primary point of contact for escalated coding issues, providing expert guidance and resolution.
- Prepare and present performance reports to senior leadership, highlighting trends, risks, and opportunities for improvement.
Qualifications
- 5+ years of experience in Risk Adjustment Coding (HCC, ICD-10-CM) within a healthcare setting, with at least 2 years in a leadership or supervisory role.
- Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent coding certification (highly preferred).
- Deep understanding of CMS risk adjustment models, Medicare Advantage, and commercial payer requirements.
- Proven ability to train, coach, and develop coding teams, with a focus on quality and compliance.
- Strong analytical skills to interpret data, identify trends, and implement data-driven solutions.
- Proficiency in EHR/EMR systems (e.g., Epic, Cerner) and coding software (e.g., 3M, Optum).
- Excellent communication and stakeholder management skills to liaise with internal and external partners.
- Bachelor’s degree in Health Information Management (HIM), Nursing, or a related field (or equivalent experience).