JobsAdvocate Health

Professional Coder II - Risk Management

Advocate Health · WI

Posted Sep 13, 2026 · We last checked this listing on Sep 20, 2026

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Likely interview questions for this role

Written from this job description, not a generic list. Each one notes what the interviewer is really checking.

Behavioral

Tell me about a time you found a diagnosis in the documentation that wasn't captured in the code set. What did you do?

real-world habit of catching missed HCC-relevant diagnoses, a core risk coding skill

Give me an example of a complex E/M encounter you coded that required careful modifier work. What made it tricky?

hands-on evidence of the professional fee coding complexity the job description emphasizes

How do you keep your accuracy up when you're coding a high volume of charts every day against a productivity target?

whether they can sustain quality under the fast-paced, deadline-driven workload described

A newer coder asks you why you coded an encounter a certain way and disagrees with your reasoning. How do you handle that conversation?

informal mentoring ability and communication style, since the role includes guiding newer staff

Tell me about a time your coding accuracy was audited or questioned. What was the outcome?

comfort with accountability and compliance review, and honesty about past mistakes

Technical

Walk me through how you would risk-adjust code a chart for a patient with multiple chronic conditions documented across several visits.

whether the candidate actually understands HCC/risk adjustment coding logic, not just CPT/ICD basics

What is the difference between coding for HCC risk adjustment and coding for straight fee-for-service reimbursement, and why does that difference matter?

depth of risk management coding knowledge versus general professional fee coding experience

How do you decide when documentation is too vague to support a code and a clinical query is needed?

judgment on compliance and query thresholds, not just rule memorization

What experience do you have working in Epic, and how did you use it day to day in your coding work?

concrete familiarity with the required EHR system rather than a vague yes

What do you know about MS-DRGs and how they apply even to a simple outpatient or short inpatient stay?

basic facility payment methodology knowledge required alongside the primarily professional coding focus

Situational

Say a physician's note lists a condition as 'history of' when it should be coded as active and ongoing. How do you handle that discrepancy?

understanding of MEAT criteria and chronic condition documentation standards used in risk adjustment

You're coding for two different specialties in the same day, each with its own set of guidelines. How do you avoid mixing up the rules?

ability to context-switch across specialties, which the posting explicitly calls out

CMS updates a guideline that affects how you code a common condition. How do you find out about that change and put it into practice?

whether the candidate stays current on federal regulation changes and compliance updates on their own

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The full job description

As published by Advocate Health.

Department: 13497 Enterprise Revenue Cycle - Coding Production Operations: Professional Coding Operations Medical and Primary Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Will support : • Risk Management and prefer the 3+ years’ experience to be in Risk Management Coding. Schedule : • First shift Monday through Friday full time 40 hours per week. Certification required : • Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA). • Preferred Certification: CRC Remote opportunity: Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range: $26.55 - $39.85 Major Responsibilities: • Independently perform complex, specialty-specific professional fee coding (CPT/HCPCS and ICD-10-CM) for physician services rendered in both office and hospital settings, ensuring expert application of modifiers and E/M guidelines, or;   • Perform entry-level facility coding for simple outpatient encounters (e.g., diagnostic imaging, labs) and basic inpatient services (e.g., uncomplicated admissions, short stays) using ICD-10-CM and ICD-10-PCS, where applicable  • Ensure all coding adheres strictly to official guidelines (e.g., provided by AAPC or AHIMA), federal regulations (CMS), and organizational compliance standards  • Identify the need for formal clinical queries for documentation clarification when necessary for professional or facility records  • Maintain high accuracy and productivity standards appropriate to the complexity of the assigned workload  • May provide informal guidance to new coding staff on professional coding nuances  ​ Licensure, Registration, and/or Certification Required: • An active coding certification issued by the American Academy of Coders (AAPC) OR American Health Information Management Association (AHIMA); Dual certifications, preferred, specifically CRC Education Required: • High School Diploma or Equivalent required  • Completion of an accredited medical coding or HIM program (or equivalent experience)  Experience Required: • Minimum of 3-5 years of direct professional fee coding experience in a multi-specialty environment is required  • Experience with professional procedural coding (e.g., surgical, interventional procedures) is preferred  • Experience with Epic or similar electronic health record systems is required  Knowledge, Skills & Abilities Required: • Proficient knowledge of medical terminology, anatomy, and pathophysiology  • Advanced proficiency in CPT/HCPCS and ICD-10-CM/PCS coding systems  • Basic understanding of facility payment methodologies (MS-DRGs) as they apply to simple encounters  • Strong analytical skills, attention to detail, and ability to context-switch between different coding guidelines  • Ability to work independently, manage a varied workload, and meet deadlines in a fast-paced environment  Physical Requirements and Working Conditions: • ​Exposed to normal office environment in a remote work setting  • Job may require occasional travel for training or meetings, therefore, may be exposed to road and weather hazards  • May need to be able to lift up to 40 lbs. occasionally (e.g., equipment)  • Sits the majority of the workday, but also may lift, reach, and bend throughout the day  • Operates all equipment necessary to perform the job  This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. #REMOTE #LI-REMOTE Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation • Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training • Premium pay such as shift, on call, and more based on a teammate's job • Incentive pay for select positions • Opportunity for annual increases based on performance Benefits and more • Paid Time Off programs • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability • Flexible Spending Accounts for eligible health care and dependent care expenses • Family benefits such as adoption assistance and paid parental leave • Defined contribution retirement plans with employer match and other financial wellness programs • Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. About Advocate Health  Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

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