Remote Coding Quality Auditor – Risk Adjustment

Centauri Health Solutions Inc; United States; Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

401(k) with company match

Tuition reimbursement

Paid time off

Job summary

Centauri Health Solutions is seeking a Coding Quality Specialist to conduct coding quality reviews and ensure ICD-10-CM codes are accurately assigned, supported by clinical documentation.

This role focuses on Medicaid line of business with potential Medicare Advantage Risk Adjustment or Commercial Risk Adjustment duties, requiring independence, strong auditing skills, and the ability to work remotely.

Qualifications

• 5+ years certified with AHIMA/AAPAHIMA credential (CCS/CCS-P/AAPC CPC/CRC)
• 3+ recent years of production coding experience in Retrospective Risk Adjustment coding (within last 6 months)
• 2+ years experience conducting coder audits in Risk Adjustment
• Medicaid/Medicare/Commercial coding knowledge (Complete Code Capture)

Responsibilities

• Perform coding quality reviews of medical records to ensure ICD-10-CM codes are accurate and supported by documentation
• Provide formal audit reports and conduct education for internal/external coders based on findings
• Maintain current knowledge of ICD-10-CM, CMS requirements, and state/federal regulations
• Pass coding quiz with 80% accuracy
• Maintain minimum 95% accuracy on audits by coding leadership
• Meet minimum productivity requirements as per project terms
• Adhere to client guidelines when superseding other guidelines
• Assist leadership with process-improvement recommendations
• Handle other related duties as required

Job description

Centauri Health Solutions is seeking a Coding Quality Specialist to conduct coding quality reviews and ensure ICD-10-CM codes are accurately assigned, supported by clinical documentation.

This role focuses on Medicaid line of business with potential Medicare Advantage Risk Adjustment or Commercial Risk Adjustment duties, requiring independence, strong auditing skills, and the ability to work remotely.