Hybrid Risk Adjustment Auditor II — Lead & Mentor

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

Benefits offered by this job

Remote work options

Competitive benefits

Paid time off

Job summary

Cambia Health Solutions is seeking a Risk Adjustment Auditor I or II for a hybrid role with three days in the office across multiple locations including Salt Lake City and Boise. The role emphasizes accurate chart reviews, auditing of coding, and collaboration with care teams to improve risk adjustment reporting.

The position requires CPC/CRC certifications and an Associate degree in Healthcare or related field, with experience increasing for a senior level.

Qualifications

• Associate degree in Healthcare or related field.
• Three years of experience (Auditor II) or one year (Auditor I) in clinical coding or auditing.
• CPC and CRC certification required.

Responsibilities

• Perform retrospective and prospective chart reviews to ensure accurate risk adjustment reporting.
• Conduct quality reviews of vendor coding in support of risk adjustment processes.
• Verify accuracy and completeness of provider-reported diagnosis codes based on medical records.

Skills

Chart review

Quality audits

Documentation accuracy

Analytical thinking

Communication

Education

Associate degree in Healthcare or related field

Tools

Microsoft Office

Job description

Cambia Health Solutions is seeking a Risk Adjustment Auditor I or II for a hybrid role with three days in the office across multiple locations including Salt Lake City and Boise. The role emphasizes accurate chart reviews, auditing of coding, and collaboration with care teams to improve risk adjustment reporting.

The position requires CPC/CRC certifications and an Associate degree in Healthcare or related field, with experience increasing for a senior level.