Senior Risk Adjustment Coding Auditor for Medicare MA

Zing Health; Illinois; On-site; USD 95,000 - 125,000; Full time

Benefits offered by this job

Medical, Dental, and Vision

401(K) match

Paid Time Off

Maternal/Paternal Leave

Life Insurance

Employee Assistance Programs

Job summary

Zing Health is seeking a Senior Risk Adjustment Coding Auditor to ensure accurate, compliant coding across Medicare Advantage programs. You will lead audits, validate records, and support RADV activities, driving quality and regulatory compliance. The role requires strong analytical skills and proficiency in Excel and coding platforms.

Join a mission-driven team focused on member-centered care, data integrity, and continuous improvement within a fast-paced, innovative environment in Illinois.

Qualifications

• Active coding certification required; CRC preferred.
• Minimum 5 years of Medicare Advantage Risk Adjustment coding and auditing experience.
• Advanced knowledge of CMS-HCC, ICD-10-CM, RADV requirements, and related standards.
• Experience auditing coding vendors and risk adjustment submissions.
• Strong analytical, organizational, and communication skills.

Responsibilities

• Review, validate, and code MA records using ICD-10-CM and CMS-HCC methods.
• Conduct QA audits to ensure coding accuracy and compliance.
• Support RADV audits, chart review, and audit readiness activities.
• Monitor coding quality and vendor performance for improvements.
• Lead quality initiatives and provide actionable recommendations to leadership.
• Offer SME guidance on ICD-10-CM, CMS-HCC, and CMS guidance.

Skills

Analytical thinking

Problem-solving

Communication

Organization

Independence

Education

Bachelor's degree in Health Information Management or related field

Tools

Microsoft Excel

Job description

Zing Health is seeking a Senior Risk Adjustment Coding Auditor to ensure accurate, compliant coding across Medicare Advantage programs. You will lead audits, validate records, and support RADV activities, driving quality and regulatory compliance. The role requires strong analytical skills and proficiency in Excel and coding platforms.

Join a mission-driven team focused on member-centered care, data integrity, and continuous improvement within a fast-paced, innovative environment in Illinois.