Prospective Coder Auditor

The Jacobson Group; Missouri; On-site; USD 32,000 - 43,000; Full time

Benefits offered by this job

Medical insurance

Vision insurance

401(k) retirement savings plan

Job summary

The Jacobson Group is seeking a Medicare risk adjustment coder to support a long-term MA risk adjustment initiative. The role involves high-volume chart review using the Innovaccer platform and requires attention to accurate, specific diagnosis coding.

You will audit and validate codes, review medical documentation, and maintain production targets of 50–80 reviews per day. Experience with Medicare data and active coding certification are essential for success.

Qualifications

• 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 (CPC, CRC, CPMA, CDEO, CCS, CCS-P, RHIA, RHIT, or CCDS).
• Experience working with Medicare and/or Medicare Advantage data.

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 populations.
• Utilize coding and EMR systems including 3M, Epic, Athena, and Cerner.
• Ensure coding accuracy and compliance with risk adjustment and outpatient coding guidelines.

Skills

Risk adjustment coding

HCC coding

Outpatient coding

Education

CPC, CRC, CPMA, CDEO, CCS, CCS-P, RHIA, RHIT, or CCDS certification

Tools

Innovaccer

3M

Epic

Athena

Cerner

Job description

Must have Prospect coding experience on resume

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, or CCDS


• Strong attention to detail and documentation review skills


• Experience working with Medicare and/or Medicare Advantage data

Key Skills:

Pay Range:

• 27/hr

• 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.