Remote Coding Quality Auditor – Risk Adjustment

Centauri Health Solutions, Inc; Phoenix (AZ); Remote; USD 85,000 - 110,000; Full time

Job summary

Centauri Health Solutions, Inc. seeks a Coding Quality Specialist to conduct quality reviews and ensure accurate ICD-10-CM coding based on clinical documentation and guidelines. You will provide audit findings, educate coders, and maintain up-to-date knowledge of regulatory requirements.

The role supports Medicaid, Medicare Advantage Risk Adjustment, or Commercial lines and is suited to a remote work environment with strong organizational and communication skills.

Qualifications

• 5+ years certified coding with AHIMA or AAPAHIMA credential.
• 3 recent years of production coding in Retrospective Risk Adjustment (last 6 months).
• 2 years auditing coders in Risk Adjustment environments.
• Medicaid primary knowledge with Medicare and Commercial coding.
• 1 year coding experience with Complete Code Capture.
• Pass coding quiz with 80% accuracy.
• Maintain 95% accuracy on audits as per leadership.

Responsibilities

• Perform coding quality reviews of medical records to ensure ICD-10-CM codes are accurate and justified by documentation.
• Provide formal audit reports and educate coders based on findings.
• Stay current with ICD-10-CM, CMS requirements, and state/federal regulations.
• Achieve minimum productivity per project terms and adhere to client guidelines.
• Recommend process improvements to enhance coding goals and outcomes.
• Handle related duties as required.

Skills

Strong written and verbal comms

Strong organizational skills

Independent remote work capability

Education

AHIMA/AAPAHIMA core coding credential

CCS/CCS-P/CPC/CRC certification

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Job description

Centauri Health Solutions, Inc. seeks a Coding Quality Specialist to conduct quality reviews and ensure accurate ICD-10-CM coding based on clinical documentation and guidelines. You will provide audit findings, educate coders, and maintain up-to-date knowledge of regulatory requirements.

The role supports Medicaid, Medicare Advantage Risk Adjustment, or Commercial lines and is suited to a remote work environment with strong organizational and communication skills.