Remote Risk-Adjustment Coding Auditor

Good Samaritan Society; Wisconsin; Hybrid; USD 29,000 - 48,000; Full time

Job summary

Sanford Health, the largest rural health system in the United States, seeks a Coding Audit Specialist to conduct quality assurance on risk adjustment data submitted to CMS and DHS. You will audit medical record documentation to verify appropriate diagnostic coding and ensure compliance with CPT/ ICD coding guidelines, CMS policy, and BadgerCare Plus risk adjustment rules.

You will develop and monitor a continuous auditing program with leadership to improve accuracy, review provider

Qualifications

• High school diploma or equivalent required.
• Demonstrated knowledge of anatomy/physiology and medical terminology.
• Completion of courses in Current Procedural Terminology and ICD-9/ICD-10 coding required.

Responsibilities

• Audit medical record documentation to ensure correct codes.
• Apply CPT, ICD-9/ICD-10 guidelines and CMS/ DHS policies.
• Identify coding deficiencies and provide management with analysis and tools.
• Maintain knowledge of CPT, ICD and HCPCS coding rules and modifiers.

Skills

Anatomy knowledge

Medical terminology

Education

Associate degree in coding/health field

Tools

Word

Excel

Access

Job description

Sanford Health, the largest rural health system in the United States, seeks a Coding Audit Specialist to conduct quality assurance on risk adjustment data submitted to CMS and DHS. You will audit medical record documentation to verify appropriate diagnostic coding and ensure compliance with CPT/ ICD coding guidelines, CMS policy, and BadgerCare Plus risk adjustment rules.

You will develop and monitor a continuous auditing program with leadership to improve accuracy, review provider