Remote ACO Coding Auditor - Medicare Risk Adjustment

Cano Health; Miami (FL); On-site; USD 75,000 - 110,000; Full time

Job summary

Cano Health is seeking an ACO Coding Auditor to review medical records and ensure Medicare Risk Adjustment codes are captured accurately for CMS and Commercial ACOs. You will act as a consultant to practices, driving quality improvements and compliance across coding procedures.

The role requires on-site and remote audits, with travel to clinics as needed. The ideal candidate has CPC/CRC/CCS-P/CCS-H/RHIT certification and 3+ years in Medicare Risk Adjustment, plus strong ICD-10/CPT expertise.

Qualifications

• Requires CPC/CRC/CCS-P/CCS-H/RHIT certification.
• 3+ years of Medicare Risk Adjustment experience.
• Proven ability to interpret CMS HCC categories and coding guidelines.
• Proficient in ICD-10 coding and CPT coding.

Responsibilities

• Performs on-site and remote clinical validation audits and interprets medical documentation to capture Medicare Risk codes.
• Guides practice team members to improve MRA coding proficiency.
• Verifies accuracy and completeness of coding per CMS guidelines.
• Analyzes medical records and translates diagnoses into Medicare Risk codes.
• Trains providers and staff on CMS Risk Adjustment coding, billing, and pay-for-performance criteria.
• Travels locally and across the United States to conduct audits.

Skills

Attention to detail

ICD-10 knowledge

Critical thinking

Communication

Education

Certified Coder (CPC/CRC/CCS-P/CCS-H/RHIT)

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Job description

Cano Health is seeking an ACO Coding Auditor to review medical records and ensure Medicare Risk Adjustment codes are captured accurately for CMS and Commercial ACOs. You will act as a consultant to practices, driving quality improvements and compliance across coding procedures.

The role requires on-site and remote audits, with travel to clinics as needed. The ideal candidate has CPC/CRC/CCS-P/CCS-H/RHIT certification and 3+ years in Medicare Risk Adjustment, plus strong ICD-10/CPT expertise.