Senior Medical Coding Auditor - Remote

Elevance Health, Inc.; St. Louis (MO); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Elevance Health, Inc. is hiring a Coding Auditor Senior to audit diagnosis data from physician and hospital records for accurate ICD-9/ICD-10 coding and risk adjustment compliance. The role supports revenue projects and RADV audits, with hybrid/virtual work and occasional in-person training from a St. Louis-area office preferred.

You will review data extracts, participate in leadership groups, and stay current with audit requirements to elevate our risk adjustment program.

Qualifications

• Requires HS diploma or equivalent and minimum of 3 years of experience as coder of medical records in physician office, hospital, or insurance/coding office setting; or any combination of education and experience, which would provide an equivalent background.
• Medical Coder certification from accredited source (e.g. AHIMA, AAPC or PMI) required.

Responsibilities

• Audits diagnosis data retrieved from physician and hospital medical records and/or data extract files for both revenue project 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. Identifies training opportunities.
• Maintains current knowledge of requirements and guidance required in the performance of audit duties.

Skills

Communication skills

ICD-9 coding

HCC coding

Medicare Advantage experience

Education

HS diploma or equivalent

BS in health sciences

Job description

Elevance Health, Inc. is hiring a Coding Auditor Senior to audit diagnosis data from physician and hospital records for accurate ICD-9/ICD-10 coding and risk adjustment compliance. The role supports revenue projects and RADV audits, with hybrid/virtual work and occasional in-person training from a St. Louis-area office preferred.

You will review data extracts, participate in leadership groups, and stay current with audit requirements to elevate our risk adjustment program.