Senior Risk Adjustment Auditor II (Hybrid/Remote)

Cambia Health Solutions; Lewiston (ID); Hybrid; USD 65.000 - 100.000; Vollzeit

Benefits dieser Stelle

Medical, dental and vision coverage

Health savings account contributions

Paid time off and holidays

401(k) with company match

Parental leave

Wellness programs

Employee Assistance Fund

Zusammenfassung

Cambia Health Solutions is seeking a Risk Adjustment Auditor I or II to perform retrospective and prospective chart reviews to ensure accurate risk adjustment reporting. You will verify codes, identify trends, and collaborate on improvement strategies in a collaborative team.

The ideal candidate has an associate degree in healthcare or related field with relevant coding experience and CPC/CRC certification.

Qualifikationen

• Associate degree in Healthcare or related field with 1 year of experience for Auditor I; 3 years for Auditor II.
• Risk Adjustment, HCC or Inpatient coding experience required.
• CPC and CRC coding certification required.
• Knowledge of ICD-9-CM/ICD-10 coding guidelines and auditing best practices.

Aufgaben

• Perform retrospective and prospective chart reviews to ensure accurate risk adjustment reporting.
• Conduct quality reviews of vendor coding in support of risk adjustment processes.
• Verify accuracy and completeness of provider-reported diagnosis codes.
• Identify trends in coding/documentation and collaborate on intervention strategies.
• Mentor junior staff and participate in special risk mitigation projects.

Kenntnisse

Chart review

Risk adjustment

HCC coding

Analytical skills

Documentation

Communication

AI tools experience

Regulatory awareness

Ausbildung

Associate degree in Healthcare or related field

CPC/CRC certification

Tools

Word

Excel

Outlook

Jobbeschreibung

Cambia Health Solutions is seeking a Risk Adjustment Auditor I or II to perform retrospective and prospective chart reviews to ensure accurate risk adjustment reporting. You will verify codes, identify trends, and collaborate on improvement strategies in a collaborative team.

The ideal candidate has an associate degree in healthcare or related field with relevant coding experience and CPC/CRC certification.