Remote Senior Medical Coder & Audit Specialist

The Elevance Health Companies, Inc.; St. Louis (MO); Hybrid; USD 90,000 - 125,000; Full time

Benefits offered by this job

merit increases

paid holidays

Paid Time Off

incentive bonus programs

medical

dental

vision

short and long term disability

401(k) +match

stock purchase plan

life insurance

welfare programs

financial education resources

Job summary

Elevance Health is seeking a Coding Auditor Senior to audit diagnosis data from physician and hospital records to ensure proper ICD-9/ICD-10 coding and compliance with risk adjustment requirements.

The role supports hybrid/virtual work with in-person training sessions and requires at least a high school diploma with 3 years of medical coding experience and a certified coder credential. Strong communication and knowledge of Medicare Advantage are preferred.

Qualifications

• Requires a high school diploma or equivalent and minimum of 3 years of experience as coder of medical records in physician office, hospital, or insurance/coding office setting.
• Medical Coder certification from an accredited source is required.

Responsibilities

• Audits diagnosis data retrieved from physician and hospital medical records and/or data extract files for revenue projects and RADV.
• Assists with National and Targeted Risk Adjustment Data Validation audits.
• Participates and represents the department in business leadership groups.
• Serves as a subject matter expert.
• Assesses and identifies training opportunities.
• Maintains current knowledge of requirements and guidance for audit duties.

Skills

Strong communication skills

Medicare Advantage experience

Education

H.S. diploma or equivalent

Medical Coder certification

Job description

Elevance Health is seeking a Coding Auditor Senior to audit diagnosis data from physician and hospital records to ensure proper ICD-9/ICD-10 coding and compliance with risk adjustment requirements.

The role supports hybrid/virtual work with in-person training sessions and requires at least a high school diploma with 3 years of medical coding experience and a certified coder credential. Strong communication and knowledge of Medicare Advantage are preferred.