Remote Medicare MRA Coding Auditor (CMS-HCC V28)

Alignment Healthcare USA, LLC; Orange (CA); Remote; USD 64,000 - 97,000; Full time

Job summary

Alignment Health is seeking an experienced MRA Coding Auditor to support QA audits of the internal Coding Analyst Team and vendors, ensuring high-quality data submitted to CMS. The role involves risk adjustment data validation, chart reviews, and process improvements.

Required: 3+ years Medicare Risk Adjustment coding, certified coder (CCS/CCS-P/CPC/CRC/RHIT/RHIA), and proficiency with MS Office and leading EHR systems. This is a remote position with competitive pay and benefits.

Qualifications

• Experience with Medicare Risk Adjustment coding in a medical group or health plan setting.
• Certified coder with CCS/CCS-P/CPC/CRC/RHIT or RHIA certification.
• Proficient in MS Office suite and health IT systems; strong numeric and analytic abilities.
• Ability to communicate professionally and train others; strong problem solving.

Responsibilities

• Supports QA audits of internal Coding Analyst Team to validate coding accuracy (95%+).
• Tracks QA audits of coding vendors and ensures CMS submission data quality.
• Collaborates with Risk Adjustment Management on data validation and coding audits.
• Analyzes audit results and supports training and process improvements.
• Protects PHI per HIPAA and complies with applicable regulations.
• Maintains knowledge through continued education and professional activities.

Skills

MS Office Suite

Communication skills

Mathematical skills

Reasoning & prioritization

Reporting skills

Education

High School Diploma or GED

Medical Coding training program

Bachelor's degree in Business Administration

Bachelor's degree in Health Care Management

Tools

Epic

Allscripts

EZCap

Athenahealth

Job description

Alignment Health is seeking an experienced MRA Coding Auditor to support QA audits of the internal Coding Analyst Team and vendors, ensuring high-quality data submitted to CMS. The role involves risk adjustment data validation, chart reviews, and process improvements.

Required: 3+ years Medicare Risk Adjustment coding, certified coder (CCS/CCS-P/CPC/CRC/RHIT/RHIA), and proficiency with MS Office and leading EHR systems. This is a remote position with competitive pay and benefits.