Remote Medicare Risk Adjustment Auditor | Certified Coder

Alignment Health; United States; Remote; USD 64.000 - 97.000; Vollzeit

Zusammenfassung

Alignment Health is seeking a remote MRA Coding Auditor to support QA audits of the Coding Analyst team and vendors, ensuring CMS data accuracy. The role includes reviews of RAF, prevalence, clinical documentation improvement, and P360 data to identify improvement opportunities for training and data quality.

You will work with Risk Adjustment Management on data validation, chart reviews, and UAT testing, and you will help improve data integrity and documentation, while upholding HIPAA standards.

Qualifikationen

• Minimum three years of Medicare Risk Adjustment coding experience required.
• Completion of a Medical Coding training program; CCS, CCS-P, CPC, or CRC licensure preferred.
• Proficient with Epic, Allscripts and EZCap systems; strong Excel skills expected.

Aufgaben

• Support QA audits of the Coding Analyst team to validate coding accuracy (HCC 95%).
• Track QA audits on coding vendors and CMS data submissions for accuracy.
• Collaborate with Risk Adjustment Management on data validation and chart reviews.
• Analyze audit results and share findings for training and process improvement.
• Maintain HIPAA compliance and protect patient information.
• Keep up with industry coding, compliance, and CEU requirements.

Kenntnisse

Communication skills

Leadership

Analytical thinking

Time management

Multitasking

Ausbildung

High School Diploma or GED

Medical Coding training program

Bachelor’s degree preferred

Tools

Epic

Allscripts

EZCap

MS Office Suite

Jobbeschreibung

Alignment Health is seeking a remote MRA Coding Auditor to support QA audits of the Coding Analyst team and vendors, ensuring CMS data accuracy. The role includes reviews of RAF, prevalence, clinical documentation improvement, and P360 data to identify improvement opportunities for training and data quality.

You will work with Risk Adjustment Management on data validation, chart reviews, and UAT testing, and you will help improve data integrity and documentation, while upholding HIPAA standards.