Senior Risk Adjustment Coder & Documentation Auditor

Galen Medical; Chattanooga (TN); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

401(k) benefits

Education reimbursement

Holiday Pay

Paid time off

Life Insurance & Long Term Disability

Job summary

Galen Medical Group in Chattanooga is seeking a Risk Adjustment Coding Auditor II to review patient records and ensure accurate ICD-10-CM coding in accordance with CMS standards. You will collaborate with physicians and coding staff to improve documentation and reimbursement.

The role emphasizes documentation improvement, compliance with HIPAA and CMS regulations, and data accuracy. Candidates should have CRC and CPC certifications and 3–5 years of coding experience, with CMS-HCC modeling

Qualifications

• CRC and CPC certification required or active
• 3–5 years of clinical coding experience
• Familiarity with CMS-HCC models and ICD-10-CM coding

Responsibilities

• Review outpatient/inpatient records to identify chronic conditions and relevant data.
• Assign accurate ICD-10-CM codes ensuring HCCs are captured per MEAT criteria.
• Identify documentation gaps and provide actionable feedback to clinicians.
• Ensure compliance with HIPAA, CMS regulations and internal policies.
• Collaborate with providers and coding staff to improve documentation and coding accuracy.

Skills

ICD-10-CM coding

CMS-HCC models

Medical terminology

EMR systems

Problem-solving

Communication

CRC/CPC certification

Education

High-school Diploma or GED

Job description

Galen Medical Group in Chattanooga is seeking a Risk Adjustment Coding Auditor II to review patient records and ensure accurate ICD-10-CM coding in accordance with CMS standards. You will collaborate with physicians and coding staff to improve documentation and reimbursement.

The role emphasizes documentation improvement, compliance with HIPAA and CMS regulations, and data accuracy. Candidates should have CRC and CPC certifications and 3–5 years of coding experience, with CMS-HCC modeling