Remote Senior Medical Coding Auditor

Elevance Health, Inc.; Miami (FL); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) + match

Paid time off

Incentive bonus programs

Job summary

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

The role supports revenue and RADV audits and participates in leadership groups. The candidate should have a coding certification and at least 3 years of medical records coding experience, with preferred familiarity in Medicare Advantage and ICD-9/HCC coding.

Qualifications

• Requires a HS diploma or equivalent and minimum 3 years of experience coding medical records in a physician office, hospital, or insurance/coding setting.
• Medical Coder certification from AHIMA, AAPC or PMI is required.

Responsibilities

• Audits diagnosis data from physician and hospital records and data extracts for revenue projects and RADV.
• Assists with National and Targeted Risk Adjustment Data Validation audits.
• Represents the department in business leadership groups.
• Identifies training opportunities as needed.
• Maintains current knowledge of audit requirements and guidance.

Skills

Auditing

Medical record coding

Data analysis

Communication

Education

High school diploma

Bachelor’s degree in health sciences

Tools

ICD-9 coding

ICD-10 coding

Job description

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

The role supports revenue and RADV audits and participates in leadership groups. The candidate should have a coding certification and at least 3 years of medical records coding experience, with preferred familiarity in Medicare Advantage and ICD-9/HCC coding.