Remote Medicare MRA Coding Auditor (CRC/CPC)

Alignment Health; California City (CA); Remote; USD 64,000 - 97,000; Full time

Job summary

Alignment Health in the United States is seeking a remote MRA Coding Auditor to support departmental QA audits of the Coding Analyst team and vendors, ensuring accurate data submissions to CMS and risk adjustment processes. You will monitor QA findings, train staff, review data flows, perform chart reviews, and ensure HIPAA compliance while staying current with coding standards.

The role requires at least three years in Medicare Risk Adjustment coding, certification, and proficiency in Epic,

Qualifications

• Minimum 3 years Medicare Risk Adjustment coding experience in a medical group or health plan setting.
• High School Diploma or GED; completion of Medical Coding training.
• Certified coder required (CCS/CCS-P/CPC/CRC).
• Technical schooling or courses to become a certified coder.

Responsibilities

• Supports regular QA audits of internal Coding Analyst Team to validate coding quality (95% HCC accuracy).
• Tracks and reports QA audits of coding vendors to verify CMS data submissions.
• Collaborates with Risk Adjustment Management on data validation and audits.
• Analyzes audit results and shares findings for training and process improvement.
• Maintains HIPAA compliance and protects PHI.
• Keeps current with industry coding standards and CEUs.
• Other duties as assigned to meet organizational needs.

Skills

Medicare coding

Risk Adjustment

QA Audits

Data analysis

Communication

Education

High School Diploma

Medical Coding training

Bachelor's degree

Tools

Epic

Allscripts

EZCap

Excel

Word

Outlook

Job description

Alignment Health in the United States is seeking a remote MRA Coding Auditor to support departmental QA audits of the Coding Analyst team and vendors, ensuring accurate data submissions to CMS and risk adjustment processes. You will monitor QA findings, train staff, review data flows, perform chart reviews, and ensure HIPAA compliance while staying current with coding standards.

The role requires at least three years in Medicare Risk Adjustment coding, certification, and proficiency in Epic,