Prospective Coder Auditor

The Jacobson Group; Remote; USD 80,000 - 100,000; Full time

Job summary

A healthcare support organization is seeking a coding specialist for ongoing Medicare initiatives. The role involves validating diagnosis codes with a daily expectation of reviewing 50 to 80 charts. Candidates need a minimum of 1 year of experience in risk adjustment coding and an active coding certification. Benefits include medical insurance, vision insurance, and a 401(k) plan. Compensation is competitive at $27/hr, with flexibility based on experience and market conditions.

Benefits

Medical insurance

Vision insurance

401(k) retirement savings plan

Qualifications

• Minimum of 1 year of experience in risk adjustment coding, HCC coding, or outpatient diagnosis coding.
• Experience working with Medicare and/or Medicare Advantage data.

Responsibilities

• Audit information pulled by the Innovaccer tool and validate diagnosis codes for accuracy.
• Perform high-volume reviews with expected daily productivity of 50–80 charts.
• Ensure coding accuracy and compliance with risk adjustment and outpatient coding guidelines.

Skills

Attention to detail

Documentation review

Risk adjustment coding

Education

Active coding certification (CPC, CRC, etc.)

Tools

3M

Epic

Athena

Cerner

Job description

This role supports an ongoing Medicare and Medicare Advantage risk adjustment initiative, focused on validating diagnosis codes to the highest level of specificity. The position involves high-volume chart review using the Innovaccer platform, with no defined end date and long-term project stability.

Responsibilities

• Audit information pulled by the Innovaccer tool and validate diagnosis codes for accuracy and specificity
• Review supporting medical documentation and make final determinations prior to provider review
• Perform high-volume reviews with expected daily productivity of 50–80 charts
• Focus exclusively on Medicare and Medicare Advantage (MA) populations
• Utilize coding and EMR systems including 3M, Epic, Athena, and Cerner
• Ensure coding accuracy and compliance with risk adjustment and outpatient coding guidelines

Requirements

• Minimum of 1 year of experience in risk adjustment coding, HCC coding, or outpatient diagnosis coding
• Ability to consistently meet daily production expectations of 50–80 reviews
• Active coding certification required (one of the following):
  • CPC
  • CRC
  • CPMA
  • CDEO
  • CCS
  • CCS-P
  • RHIA
  • RHIT
  • CCDS
• Strong attention to detail and documentation review skills
• Experience working with Medicare and/or Medicare Advantage data

Pay Range

27/hr

We understand salary is an important factor in your job search and encourage you to apply even if your desired compensation falls outside this range. The final rate is determined based on several factors including relevant experience, education, certifications, and market conditions.

Benefits

• Medical insurance
• Vision insurance
• 401(k) retirement savings plan

Contact

[phone]

[e-mail]

Refer a Colleague

Do you know someone who would be interested in this project? Submit your referral directly by emailing the Jacobson contact listed above or submitting them through this form. If your referral is hired for a contract assignment and meets all other eligibility criteria, you will receive a referral bonus!

Equal Opportunity Employer

The Jacobson Group is committed to fostering an inclusive and equitable workplace that reflects the diverse communities we serve. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status or any other protected characteristic as defined by applicable law. We believe that diversity of thought, background and experience strengthens our team and drives innovation. All employment decisions are based on qualifications, merit and business needs.

If you require a reasonable accommodation to complete the application process or participate in an interview, please contact us at [e-mail] or [phone] to make a request.