Remote Coding Quality Auditor - Risk Adjustment

Centauri Health Solutions, Inc.; Oregon; Hybrid; USD 70,000 - 95,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

401(k) plan with company match

Tuition reimbursement

Paid time off and holidays

Company-paid training and equipment

Performance-based bonus

Volunteer time off

Employee referral bonus

Job summary

Centauri Health Solutions is seeking a Coding Quality Specialist to conduct coding quality reviews of medical records, ensuring ICD-10-CM codes are accurately tied to clinical documentation. The role emphasizes audit reporting, education for coders, and adherence to CMS and state regulations.

The ideal candidate will have extensive AHIMA/AAPC credentials, several years in Risk Adjustment coding, and the ability to work independently in a remote environment while maintaining high accuracy and

Qualifications

• Minimum of 5 years certified coding credentials (AHIMA or AAPC)
• Minimum of 3 years production coding in Retrospective Risk Adjustment (last 6 months)
• Minimum of 2 years experience auditing coders in Risk Adjustment
• Medicaid/Medicare/Commercial coding experience (at least 1 year for Complete Code Capture)
• Able to work independently in a remote environment

Responsibilities

• Perform coding quality reviews of medical records to ensure ICD-10-CM codes are accurate and supported
• Provide formal audit reports and educate coders based on findings
• Maintain up-to-date knowledge of ICD-10-CM, CMS requirements, and regulations
• Achieve 80% accuracy on coding quizzes
• Maintain 95% accuracy in audits as per leadership
• Meet minimum productivity requirements per project terms
• Adhere to client guidelines when overruling other guidelines
• Suggest process improvements to enhance coding outcomes
• Handle other related duties as required

Skills

Strong written communication

Strong verbal communication

Strong organizational skills

Technical savvy

Remote work capability

Education

AHIMA/AAPC Coding Credentials (CCS/CCS-P/CPC/CRC)

Retrospective Risk Adjustment coding experience

Coder audits in Risk Adjustment

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Job description

Centauri Health Solutions is seeking a Coding Quality Specialist to conduct coding quality reviews of medical records, ensuring ICD-10-CM codes are accurately tied to clinical documentation. The role emphasizes audit reporting, education for coders, and adherence to CMS and state regulations.

The ideal candidate will have extensive AHIMA/AAPC credentials, several years in Risk Adjustment coding, and the ability to work independently in a remote environment while maintaining high accuracy and