Risk Adjustment Medical Coder - Team Leader

Risk Adjustment Medical Coder Team Leader

Work-from-Home | Metro Manila, Pampanga, Cebu & Nationwide

Build Your Career in Healthcare Coding Leadership!

We are looking for an experienced and detail-oriented Risk Adjustment Medical Coder Team Leader to join our growing healthcare operations team.

This role is ideal for a PHRN with a CPC certification and strong Risk Adjustment (RA) coding experience who is ready to take on a leadership role. The successful candidate will provide coding expertise, coach and support medical coders, monitor team performance, and help ensure accuracy, compliance, and productivity across the account.

If you have a strong background in Risk Adjustment Coding and experience as an SME, Team Lead, or people manager, we encourage you to apply!

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Position

Risk Adjustment Medical Coder Team Leader

Work Setup

• Work From Home (TWFH)
• Non-Voice healthcare operations
• Open to qualified candidates from Metro Manila, Pampanga/Central Luzon, Cebu, and other locations in the Philippines
• Willing to work on a shifting schedule based on business requirements
• May include night shifts, weekends, and holidays

Compensation

PHP 50,000 Package

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Key Responsibilities

As a Risk Adjustment Medical Coder Team Leader, you will provide both coding expertise and operational leadership to a team responsible for Risk Adjustment coding activities.

Your responsibilities may include:

• Lead, supervise, and support a team of Risk Adjustment Medical Coders.
• Provide day-to-day guidance and support to team members regarding coding-related concerns.
• Review complex coding cases and provide appropriate coding guidance and recommendations.
• Ensure accurate assignment of diagnosis codes based on medical documentation and applicable coding guidelines.
• Perform or support quality audits to identify coding errors, documentation gaps, and opportunities for improvement.
• Monitor team performance against established quality, productivity, accuracy, and turnaround-time targets.
• Conduct regular coaching and feedback sessions with team members.
• Identify individual and team-level performance gaps and develop appropriate action plans.
• Serve as a subject matter expert (SME) for Risk Adjustment Coding processes and coding-related issues.
• Assist with training, onboarding, nesting, and upskilling of new and existing coders.
• Ensure team members consistently follow established coding guidelines, client requirements, and internal processes.
• Support the implementation of coding updates, process changes, and client-specific requirements.
• Investigate recurring coding errors and recommend corrective or preventive actions.
• Collaborate with Quality, Training, Operations, and other internal teams to address coding and performance concerns.
• Assist in resolving escalated coding cases and complex documentation scenarios.
• Monitor daily operational performance and communicate significant concerns or trends to management.
• Prepare and provide team performance updates, coding quality reports, and other required documentation.
• Participate in process improvement initiatives designed to improve coding accuracy, productivity, and overall account performance.
• Promote a culture of quality, accountability, teamwork, and continuous learning.

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Qualifications

Required Qualifications

• Philippine Registered Nurse (PHRN).
• CPC certification or equivalent coding certification relevant to Risk Adjustment Coding.
• At least 2–3 years of Risk Adjustment Medical Coding experience.
• Strong knowledge of Risk Adjustment Coding principles, medical terminology, and diagnosis coding.
• Strong understanding of medical documentation and the relationship between documentation and accurate diagnosis coding.
• Excellent attention to detail and analytical skills.
• Ability to interpret and analyze medical records and clinical documentation.
• Strong written and verbal communication skills.
• Ability to work independently and effectively in a work-from-home environment.
• Willingness to work on a shifting schedule, including night shifts, weekends, and holidays when required.

Preferred Qualifications

• Previous experience as a Risk Adjustment Coding SME, Team Leader, Supervisor, or People Manager.
• Experience coaching or mentoring medical coders.
• Experience conducting coding audits or quality reviews.
• Experience handling complex or escalated Risk Adjustment coding cases.
• Experience monitoring coding KPIs, including accuracy, productivity, quality, and turnaround time.
• Experience supporting US healthcare accounts.
• Familiarity with commonly used Risk Adjustment models, coding guidelines, and payer requirements is an advantage.
• Experience with coding, EHR, encoder, or healthcare documentation systems is a plus.

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Key Skills

Risk Adjustment Coding | Medical Coding | ICD-10-CM | Medical Terminology | Clinical Documentation | Coding Quality Assurance | Coding Audit | Team Leadership | Coaching & Mentoring | SME Support | Performance Management | US Healthcare Operations

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What We’re Looking For

We are looking for a healthcare coding professional who can combine strong technical coding knowledge with effective team leadership.

The ideal candidate is:

• Detail-oriented and highly focused on coding accuracy.
• Confident in interpreting medical records and clinical documentation.
• Able to coach and develop medical coders.
• Comfortable handling complex coding questions and escalations.
• Results-oriented and capable of managing team performance.
• Organized and able to prioritize multiple operational requirements.
• Adaptable to changes in coding guidelines, client requirements, and processes.
• Comfortable working independently in a remote environment.
• Committed to maintaining high standards of quality, compliance, and productivity.

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Why Join Us?

• 💻 Work-from-Home setup
• 💰 PHP 50,000 package
• 🏥 Opportunity to work in US healthcare operations
• 📚 Utilize and further develop your Risk Adjustment Coding expertise
• 👥 Leadership, coaching, and people-management opportunities
• 📈 Career growth and professional development
• 🌎 Work with healthcare processes supporting the US market
• 🏠 Open to qualified candidates nationwide

Accepting Applicants From:

Metro Manila | Pampanga | Central Luzon | Cebu | Other Philippine Locations

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Ready to Take the Next Step?

If you are a PHRN with CPC certification and 2–3 years of Risk Adjustment Medical Coding experience, and you're ready to grow into or continue your career in a Team Leader/SME role, we encourage you to apply.

Apply now and take your Risk Adjustment Coding career to the next level!