Remote Quality Coding Auditor - Risk Adjustment

Centauri Health Solutions, Inc.; Phoenix (AZ); Teletrabalho; USD 90 000 - 130 000; Tempo integral

Resumo da oferta

Centauri Health Solutions, Inc. is seeking a Coding Quality Specialist to conduct coding quality reviews for Medicaid, Medicare, and Commercial lines, ensuring ICD-10-CM codes align with clinical documentation and guidelines.

The role requires 5+ years of certified coding credentials (AHIMA/AAPC) and 2+ years of risk adjustment audits, with strong communication, organizational skills, and the ability to work remotely in a fast-paced environment.

Qualificações

• Minimum of 5 years certified with a core coding credential (AHIMA/AAPAHIMA CCS/CCS-P or AAPC CPC/CRC).
• Minimum of 3 years of recent production coding experience in Retrospective Risk Adjustment (last 6 months).
• Minimum of 2 years auditing coder work in Risk Adjustment.
• Medicaid coding knowledge (primary) with Medicare/Commercial exposure; Complete Code Capture within at least 1 year.
• No apprentice credentials accepted; strong organizational and communication skills; proficient in basic IT tools; remote work capability.

Responsabilidades

• Perform coding quality reviews of medical records to ensure ICD-10-CM codes are accurate and supported by clinical documentation.
• Provide formal audit reports and educate coders based on findings.
• Maintain current knowledge of ICD-10-CM, CMS requirements, and state/federal regulations.
• Achieve audit accuracy targets (e.g., 95%+).
• Meet productivity requirements per project terms.
• Adhere to client guidelines when overriding other guidelines.
• Suggest process improvements to improve coding outcomes.

Conhecimentos

Organizational skills

Technical proficiency

Microsoft Outlook

Microsoft Word

Microsoft Excel

Written communication

Verbal communication

Remote work capability

Formação académica

AHIMA/AAPAHIMA CCS/CCS-P/CPC/CRC certification

Ferramentas

Microsoft Outlook

Microsoft Word

Microsoft Excel

Descrição da oferta de emprego

Centauri Health Solutions, Inc. is seeking a Coding Quality Specialist to conduct coding quality reviews for Medicaid, Medicare, and Commercial lines, ensuring ICD-10-CM codes align with clinical documentation and guidelines.

The role requires 5+ years of certified coding credentials (AHIMA/AAPC) and 2+ years of risk adjustment audits, with strong communication, organizational skills, and the ability to work remotely in a fast-paced environment.