Remote Coding Quality Specialist – Risk Adjustment

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

Benefits offered by this job

Comprehensive medical, dental, vision,

401(k) plan with company match

Tuition reimbursement

Paid time off

Job summary

Centauri Health Solutions Inc. is seeking a Coding Quality Specialist to perform coding quality reviews and ensure ICD-10-CM codes are supported by clinical documentation across Medicaid, Medicare, and Commercial lines.

You will provide audit findings, education, and maintain knowledge of CMS requirements and state/federal regulations. Ideal candidates have 5+ years of AHIMA/AAPC credentials (CCS/CCS-P/CPC/CRC), plus experience with risk adjustment coding and coder audits, and the ability to

Qualifications

• Minimum of 5 years certified with a core coding credential from AHIMA or AAPAHIMA – CCS, CCS-P, AAPC – CPC, CRC.
• Minimum of 3 recent years of production coding experience in Retrospective Risk Adjustment coding.
• Minimum of 2 years experience conducting coder audits in the Risk Adjustment environment.
• Required code set knowledge and coding experience in Medicaid (primary), Medicare, Commercial.
• Minimum of 5 years certified with a core coding credential from AHIMA or AAPAHIMA – CCS, CCS-P, AAPC – CPC, CRC (no apprentice credentials).
• Strong organizational skills.
• Technical savvy with high level of competence in basic computers, Outlook, Word, and Excel.
• Strong written and verbal communication skills.
• Ability to work independently in a remote environment.

Responsibilities

• Perform coding quality reviews of medical records to ensure ICD-10-CM codes are accurate.
• Provide formal audit reports and conduct education to coders based on findings.
• Maintain knowledge of ICD-10-CM codes, CMS requirements, and regulations.
• Pass coding quizzes with 80% accuracy and maintain 95% audit accuracy.
• Meet minimum productivity requirements as outlined by project terms.
• Adhere to client guidelines when superseding other guidelines.
• Assist leadership with process improvement recommendations.

Skills

Organizational skills

Written and verbal communication

Remote working

Microsoft Outlook

Microsoft Word

Excel

Education

AHIMA or AAPCA credential (CCS/CCS-P/AAPC CPC/CRC)

Tools

Microsoft Outlook

Microsoft Word

Excel

Job description

Centauri Health Solutions Inc. is seeking a Coding Quality Specialist to perform coding quality reviews and ensure ICD-10-CM codes are supported by clinical documentation across Medicaid, Medicare, and Commercial lines.

You will provide audit findings, education, and maintain knowledge of CMS requirements and state/federal regulations. Ideal candidates have 5+ years of AHIMA/AAPC credentials (CCS/CCS-P/CPC/CRC), plus experience with risk adjustment coding and coder audits, and the ability to