Risk Adjustment Consultant

Intus Technologies, Inc.

Job Overview

Location

Remote-USA

Job Type

Full-time

Full Job Description

📋 Description

• The Risk Adjustment Consultant at Intus Technologies, Inc. plays a critical role in ensuring accurate diagnosis capture, compliant documentation, and optimized revenue integrity for Programs of All-Inclusive Care for the Elderly (PACE) programs, directly supporting financial performance and regulatory compliance for some of the most clinically complex and socially vulnerable seniors in the U.S. healthcare system.
• This role is embedded within the IRIS team and serves as a trusted advisor to clinical staff, implementation teams, project managers, and client leadership, combining technical coding expertise with client-facing education and workflow improvement to drive sustainable operational excellence.
• Day-to-day responsibilities include conducting detailed medical record reviews using ICD-10-CM Official Guidelines, AHA Coding Clinic, and internal IRIS Coding Guidelines to ensure diagnostic accuracy and compliance with CMS risk adjustment standards.
• The consultant completes Pre-Encounter Preparation (PEP) and concurrent coding workflows with a target accuracy score of 95% or higher, while monitoring analytics dashboards to identify documentation gaps, coding trends, and improvement opportunities across assigned PACE clients.
• As the primary client contact, the consultant provides ongoing risk adjustment guidance, collaborates with providers to enhance documentation quality and completeness, delivers structured feedback and one-on-one coaching, and leads monthly metric reviews to assess performance and recommend corrective action plans.
• Training delivery is a core function, involving the design and facilitation of onsite training during onboarding, go-live, and optimization phases—including Risk Adjustment 101, PEP training, and provider coaching—as well as hosting virtual sessions on documentation excellence, analytics dashboards, and coding refreshers, with biweekly office hours recorded for asynchronous learning.
• The consultant develops and executes customized onboarding plans, coordinates risk adjustment deliverables across platform teams and service lines, and supports workflow design by recommending enhancements based on client feedback, quality reviews, and data insights to strengthen documentation and coding processes.
• Compliance and quality assurance duties include supporting accurate risk adjustment data submissions to CMS, participating in internal audits and coding accuracy checks, and maintaining detailed documentation of coding decisions, audit notes, and workflow recommendations for traceability and continuous improvement.
• The role requires deep knowledge of CMS-HCC models, RAF scoring, and risk adjustment methodologies, proficiency in EMR/EHR systems and coding platforms, strong analytical skills to interpret trends and develop actionable recommendations, and excellent written and verbal communication skills for delivering training both onsite and virtually.
• Success in this role demands the ability to work independently in a remote environment while managing deadlines and client expectations, with willingness to travel to support client go-live events for the IRIS platform.
• IntusCare is the only end-to-end ecosystem built specifically for PACE programs, replacing outdated technology with purpose-built solutions for care coordination, risk adjustment, population health, and utilization management, empowering teams to improve outcomes for dual-eligible seniors.
• The consultant contributes directly to IntusCare’s mission of helping PACE programs deliver exceptional care, strengthen financial performance, and stay compliant through accurate, compliant, and proactive risk adjustment operations.
• This position offers the opportunity to grow expertise in senior care populations, clinical documentation improvement, and healthcare revenue integrity while working with a mission-driven organization dedicated to serving some of the nation’s most vulnerable patients.

🎯 Requirements

• Current CPC, CCS, RHIT, and CRC (Certified Risk Adjustment Coder) certifications are required.
• Minimum of 5 years of professional experience in medical coding with a specific focus on risk adjustment methodologies.
• High school diploma or equivalent is required; an Associate’s or Bachelor’s degree is preferred.

🏖️ Benefits

• Fully remote work arrangement based in the United States, offering flexibility and work-life balance.
• Competitive salary range of $90K–$100K, with compensation determined by experience, skills, and organizational needs.
• Opportunity to work with a purpose-driven organization improving care and financial outcomes for socially vulnerable and clinically complex senior populations.

Skills & Technologies

Remote

$90k-100k

Degree Required

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Intus Technologies, Inc.

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About Intus Technologies, Inc.

Intus Technologies provides cloud-based data and analytics platforms for healthcare payers and providers. The company’s SaaS solutions ingest claims, clinical, and financial data to deliver population-health insights, risk adjustment analytics, quality-measure reporting, and payment-integrity workflows. Core products include the Intus Data Platform for scalable data ingestion and normalization, and Intus Analytics for predictive modeling and care-gap identification. Founded in 2014, the firm serves Medicare Advantage, Medicaid, and commercial health plans across the United States.

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