Remote MRA Coding Auditor & CRC Specialist

Alignment Health; California; Remote; USD 64,000 - 97,000; Full time

Benefits offered by this job

Remote work

Job summary

Alignment Health is seeking a MRA Coding Auditor for a fully remote role in the United States. The role supports QA audits of coding analysts and vendors to ensure high-quality submissions to CMS and accurate risk adjustment data, including RAF and clinical documentation improvement efforts.

The ideal candidate has a minimum of three years in Medicare Risk Adjustment coding, with a high school diploma (coding program), and preferably a Bachelor’s degree in a related field.

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 related field preferred.

Responsibilities

• Perform QA audits of internal Coding Analyst Team to validate coding quality (95% HCC accuracy).
• Track and report progress of QA audits on coding vendors for CMS submissions accuracy.
• Collaborate with Risk Adjustment Management on data validation / coding audits for completeness and accuracy.
• Analyze audit results and share findings for training, documentation improvement, and process improvements.
• Protect and disclose PHI per HIPAA; ensure compliance with regulatory standards.
• Maintain knowledge through workshops and CEUs related to coding certifications.
• Other duties as assigned to meet organizational needs.

Skills

MS Office

Epic

Allscripts

EZCap

Communication

Leadership

Problem Solving

Time Management

Education

High School Diploma or GED

Medical Coding training program

Bachelor's degree (preferred) in Business Admin / Healthcare Management or related field

Tools

Epic

Allscripts

EZCap

MS Office

Job description

Alignment Health is seeking a MRA Coding Auditor for a fully remote role in the United States. The role supports QA audits of coding analysts and vendors to ensure high-quality submissions to CMS and accurate risk adjustment data, including RAF and clinical documentation improvement efforts.

The ideal candidate has a minimum of three years in Medicare Risk Adjustment coding, with a high school diploma (coding program), and preferably a Bachelor’s degree in a related field.