Clinical Documentation & Coding Specialist

About SynapticureAs a patient and caregiver-founded company, Synapticure provides instant access to expert neurologists, cutting-edge treatments and trials, and wraparound care coordination and behavioral health support in all 50 states through a virtual care platform. Partnering with providers and health plans, including CMS' new GUIDE dementia care model, Synapticure is dedicated to transforming the lives of millions of individuals and their families living with neurodegenerative diseases such as Alzheimers, Parkinsons, and ALS.Our clinical and operational teams rely on accurate, high-quality documentation to ensure exceptional patient care, regulatory compliance, and optimal performance in value-based care programs. This role sits at the intersection of clinical reasoning, coding expertise, and documentation excellence.
The RoleSynapticure is seeking an experienced Clinical Documentation & Coding Specialist with deep expertise in Hierarchical Condition Category (HCC) coding and strong clinical interpretation skillsparticularly in neurology, dementia, psychiatry, and behavioral health.In this role, you will execute the full lifecycle of chart preparation, diagnosis identification, documentation review, and accurate coding both before and after patient encounters. Your work ensures that providers have comprehensive, clinically supported information during visits and that Synapticure captures all relevant chronic conditions to support high-quality care and value-based performance.The ideal candidate is meticulous, clinically fluent, and highly organizedable to synthesize complex documentation from multiple sources and apply CMS risk adjustment guidelines with precision. You must be comfortable working independently, applying feedback consistently, and operating in a fast-paced, highly regulated environment.

Job Duties What youll be doing

• Perform comprehensive chart preparation for dementia-care patients by reviewing multi-year clinical histories, consult notes, diagnostics, medication lists, and hospital records.
• Identify suspected, undocumented, or insufficiently supported chronic conditions and prepare findings for provider review.
• Review medical records for documentation gaps, inconsistencies, or unclear diagnostic specificity and flag issues in advance of visits.
• Accurately assign ICD-10-CM codes in compliance with CMS HCC guidelines and official coding rules.
• Validate that all diagnoses meet MEAT documentation standards and are supported within the medical record.
• Review post-visit documentation to reconcile diagnoses, address missed opportunities, and provide coding recommendations.
• Query providers for clarification when documentation is incomplete, ambiguous, or inconsistent, ensuring compliant query practices.
• Provide feedback and education to providers on documentation needs for accurate HCC capture.
• Collaborate with revenue cycle, CDI, and auditing teams to close documentation gaps and improve workflows.
• Maintain high accuracy and productivity benchmarks in both chart prep and coding.
• Participate in internal and external audits and implement corrective actions as needed.
• Stay current with CMS, HHS, and payer-specific risk adjustment updates, especially those impacting neurology and dementia care.
• Ensure CPT/HCPCS/ICD-10 coding for encounter-based services is accurate, compliant, and ready for timely claim submission.

Requirements What we look for in you

• High school diploma required; Associates or Bachelors degree in a health-related field preferred.
• Active CPC or CCS certification (AAPC or AHIMA).
• CRC certification strongly preferred.
• 23+ years of medical coding experience, including 12 years in HCC/risk adjustment.
• Demonstrated experience performing detailed pre-visit chart preparation.
• Experience coding neurology, psychiatry, behavioral health, or dementia conditions (strongly preferred).
• Strong understanding of ICD-10-CM, HCC models, MEAT criteria, and CMS/HHS risk adjustment principles.
• Ability to analyze medical records, identify unsupported diagnoses, and detect coding gaps.
• Excellent communication skills for provider interaction and compliant query writing.
• Proficiency with coding software, EHR platforms, and technology tools.
• Ability to work independently, maintain accuracy under volume, and meet tight deadlines.

Preferred Qualifications

• Experience with multiple payer HCC methodologies (CMS RAF, ACA HHS, MA, etc.).
• Knowledge of CPT and HCPCS coding rules.
• Experience in managed care, value-based care programs, or large health systems.
• Advanced clinical literacy in neurology and dementia-related documentation patterns.
• Experience navigating multiple EHR systems and data workflows.
• Strong critical thinking and pattern-recognition skills for identifying clinical clues and documentation opportunities.

Were founded by a patient and caregiver, and were a remote-first company. This means our values are at the heart of everything we do, and while were located all across the country, these principles tie us together around a common identity:

• Relentless focus on patients and caregivers. We provide exceptional experiences for the patients we serve and put them first in all decisions.
• Embody the spirit and humanity of those living with neurodegenerative disease. With empathy, compassion, kindness, and hope, we honor the seriousness of our patients circumstances.
• Seek to understand, and stay curious. We listen firstwith authenticity, humility, and a commitment to continual learning.
• Embrace the opportunity. We act with urgency and intention toward our mission.

Competitive salary based on experienceComprehensive medical, dental, and vision coverage401(k) plan with employer matchRemote-first work environment with home office stipendGenerous paid time off and sick leaveProfessional development and career growth opportunities