Remote MRA Coding Auditor: Certified Risk Adjustment Coder

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

Job summary

Alignment Health is seeking a remote MRA Coding Auditor to support QA audits of the Coding Analyst team and vendors, ensuring accurate data submitted to CMS.

You will collaborate with Risk Adjustment Management on data validation, chart reviews, and process improvements, maintaining HIPAA compliance and professional standards.

Required certifications and 3+ years in Medicare Risk Adjustment coding, with a high school diploma and coding training; bachelor’s in a related field is preferred.

Qualifications

• Minimum three years of Medicare Risk Adjustment coding in a medical group or health plan setting.
• High School Diploma or GED; completion of a Medical Coding training program.
• Bachelor’s degree in Business Administration, health Care Management or in a related field.
• Technical School or courses that are required to become a certified coder.
• Certified Coder required, CCS, CCS-P, CPC, or CRC.

Responsibilities

• Supports QA audits of internal Coding Analyst Team to validate coding quality (95% HCC accuracy).
• Tracks and reports progress of QA audits on coding vendors for CMS submissions.
• Collaborates with Risk Adjustment Management on MRA data validation and coding audits.
• Analyzes audit results to support training and process improvements.
• Ensures HIPAA compliance and protects PHI in line with standards.
• Maintain CEUs and professional knowledge through workshops and publications.

Skills

Medicare risk adjustment coding

MS Office

Epic

Allscripts

Excel

Communication

Leadership

Education

High School Diploma or GED

Medical Coding training

Bachelor’s degree in Business Administration or Healthcare Management

Tools

EZCap

Job description

Alignment Health is seeking a remote MRA Coding Auditor to support QA audits of the Coding Analyst team and vendors, ensuring accurate data submitted to CMS.

You will collaborate with Risk Adjustment Management on data validation, chart reviews, and process improvements, maintaining HIPAA compliance and professional standards.

Required certifications and 3+ years in Medicare Risk Adjustment coding, with a high school diploma and coding training; bachelor’s in a related field is preferred.