Risk Adjustment Coding Auditor (CPC/CRC)

Martin's Point Health Care; Portland (ME); Remote; USD 76,000 - 93,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Retirement plan

Paid time off

Job summary

Martin's Point Health Care in Maine seeks a Risk Adjustment Auditor to ensure accurate coding and compliant documentation across professional, inpatient, and outpatient services. You will audit medical records and validate coding to support risk adjustment programs.

The role requires ICD-10/CPT expertise, strong auditing skills, and the ability to work independently. A CPC/COC or CRC certification is preferred, with ongoing education and collaboration with the Coding Advisory Committee.

Qualifications

• Associates degree or related education/experience.
• 5+ years clinical coding experience with risk adjustment coding.
• Certified CPC/COC or CRC required.

Responsibilities

• Audit medical records for risk adjustment compliance.
• Review physician notes, labs, and reports to capture diagnoses.
• Assign ICD-10 codes reflecting patient conditions.
• Stay current with HIPAA, coding guidelines, and CMS standards.
• Meet team performance metrics.
• Conduct RADV/IPM chart reviews.
• Participate in Coding Advisory Committee.

Skills

ICD-10/CPT coding

Medical terminology

Auditing skills

Communication skills

Problem solving

Organizational skills

Independent work

Education

Associate degree

Job description

Martin's Point Health Care in Maine seeks a Risk Adjustment Auditor to ensure accurate coding and compliant documentation across professional, inpatient, and outpatient services. You will audit medical records and validate coding to support risk adjustment programs.

The role requires ICD-10/CPT expertise, strong auditing skills, and the ability to work independently. A CPC/COC or CRC certification is preferred, with ongoing education and collaboration with the Coding Advisory Committee.