Remote Coding Quality Auditor - Risk Adjustment

Centauri Health Solutions, Inc.; United States; Remote; USD 110,000 - 140,000; Full time

Job summary

Centauri Health Solutions, Inc. seeks a Coding Quality Specialist to review diagnoses coding accuracy against clinical documentation and official guidelines. This remote role focuses on Medicaid line of business with potential Medicare Advantage and Commercial risk adjustment duties.

You will generate formal audit reports, educate internal and external coders, and maintain current knowledge of regulatory requirements. Strong communication is essential.

Qualifications

• Certified coding professional with AHIMA or AAPC credentials.
• Minimum 5 years of certified coding experience in risk adjustment.
• Experience auditing coders in Medicaid/Medicare environments.
• Expert knowledge of ICD-10-CM and CMS guidelines.

Responsibilities

• Perform coding quality reviews to ensure ICD-10-CM codes match clinical docs.
• Provide formal audit reports and coder education based on findings.
• Stay current on ICD-10-CM codes and CMS/state/federal requirements.
• Maintain high accuracy in audits and meet productivity targets.
• Adhere to client guidelines when prioritizing coding guidance.
• Suggest process improvements to enhance coding outcomes.
• Handle related duties as required.

Skills

Organizational skills

Communication skills

Microsoft Office

Education

AHIMA/AAPC certification

Job description

Centauri Health Solutions, Inc. seeks a Coding Quality Specialist to review diagnoses coding accuracy against clinical documentation and official guidelines. This remote role focuses on Medicaid line of business with potential Medicare Advantage and Commercial risk adjustment duties.

You will generate formal audit reports, educate internal and external coders, and maintain current knowledge of regulatory requirements. Strong communication is essential.