Remote Medicare MRA Auditor & Certified Coder

Alignment Healthcare USA, LLC; Orange (CA); Teletrabalho; USD 64 000 - 97 000; Tempo integral

Resumo da oferta

Alignment Health seeks a skilled MRA Coding Auditor to support quality assessment audits of internal coding teams and vendors, ensuring accurate data submitted to CMS. You will assist in RAF and related audits, identify improvement opportunities, and collaborate with stakeholders to enhance data integrity.

The role requires CCS/CPC/CRC certification, 3+ years in Medicare Risk Adjustment coding, and proficiency with Epic, Allscripts, and EZCap.

Qualificações

• Must have CCS/CCS-P/CPC/CRC coder certification.
• Minimum three years Medicare Risk Adjustment coding experience.
• Experience with CMS data submission and RAF analytics.
• Proficient in MS Office and medical coding software.

Responsabilidades

• Perform ongoing QA audits of internal Coding Analyst Team to validate coding accuracy (95% HCC accuracy).
• Track and report QA audits for coding vendors and CMS submissions.
• Collaborate with Risk Adjustment Management on data validation and coding accuracy for CMS submissions.
• Analyze audit results and share with Manager for training and process improvements.
• Maintain HIPAA compliance and protect PHI; follow applicable regulations and procedures.
• Stay current with industry coding, compliance, and HCC issues; complete CEUs.
• Other duties as assigned to support organizational needs.

Conhecimentos

MS Office

Communication

Analytical skills

Problem solving

Time management

Leadership

Formação académica

High School Diploma or GED

Medical Coding training program

Bachelor’s degree in related field preferred

Ferramentas

Epic

Allscripts

EZCap

Excel

Descrição da oferta de emprego

Alignment Health seeks a skilled MRA Coding Auditor to support quality assessment audits of internal coding teams and vendors, ensuring accurate data submitted to CMS. You will assist in RAF and related audits, identify improvement opportunities, and collaborate with stakeholders to enhance data integrity.

The role requires CCS/CPC/CRC certification, 3+ years in Medicare Risk Adjustment coding, and proficiency with Epic, Allscripts, and EZCap.