Hybrid Risk Adjustment Auditor II - Impactful Coding

Cambia Health; Lewiston (ID); Hybrid; USD 58,000 - 78,000; Full time

Benefits offered by this job

Remote work options

Competitive salary

401(k) with company match

Job summary

Cambia Health is seeking a Risk Adjustment Auditor I or II for a hybrid role with 3 days in office across several western offices, including Lewiston. The team conducts chart reviews to ensure accurate risk adjustment reporting and supports training and quality improvements.

Strong coding knowledge and CPC/CRC certification are required for success. Auditor I/II roles differ by years of experience (1 vs 3) in clinical coding or auditing, with a path to mentor more junior staff.

Qualifications

• Associate degree in healthcare or related field is required.
• 1–3 years of clinical coding or auditing experience for Auditor I/II.
• Risk Adjustment, HCC or inpatient coding knowledge highly desired.
• CPC and CRC certifications are required.

Responsibilities

• Perform retrospective and prospective chart reviews for risk adjustment.
• Quality review vendor coding to support risk adjustment processes.
• Verify accuracy and completeness of provider diagnosis codes.
• Identify trends in coding/documentation and communicate with leadership.
• Support process and quality improvement initiatives and comply with regulations.

Skills

Chart reviews

Quality audits

Coding guidelines

Trend identification

Office suite (Word/Excel/Outlook)

AI tools usage

Education

Associate degree in Healthcare or related field

Tools

Word

Excel

Outlook

Job description

Cambia Health is seeking a Risk Adjustment Auditor I or II for a hybrid role with 3 days in office across several western offices, including Lewiston. The team conducts chart reviews to ensure accurate risk adjustment reporting and supports training and quality improvements.

Strong coding knowledge and CPC/CRC certification are required for success. Auditor I/II roles differ by years of experience (1 vs 3) in clinical coding or auditing, with a path to mentor more junior staff.