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Medicare Risk Adjustment Coding/Auditor, Prior CMS-HCC V28 Required
Alignment HealthMRA Coding Auditor ensuring accurate Medicare Risk Adjustment data for CMS. Engaging with QA audits and compliance in a fully remote setting.
Posted 7/31/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $64,384 - $96,577 per yearWebsite
Core Competencies
Role fitCore Competencies
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Demonstrates expertise in Medicare Risk Adjustment coding and compliance with federal, state, and local regulations. Proficient in conducting quality assurance audits and analyzing data to improve coding accuracy and training documentation.
Highest-signal resume keywords
Medicare Risk Adjustment CodingQuality Assurance AuditsCertified Coder (CCS, CCS-P, CPC, CRC, RHIT, RHIA)Proficient in MS Office SuiteExperience with Epic, Allscripts, EZCap, Athenahealth
ATS Keywords
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Hard Skills
Medicare Risk Adjustment CodingQuality Assurance AuditsData AnalysisCoding Accuracy VerificationMedical Coding Training Completion
Tools & Technologies
MS Office SuiteEpicAllscriptsEZCapAthenahealth
Certifications & Qualifications
CCSCCS-PCPCCRCRHITRHIA
Industry Keywords
Coding AnalystMRA Data ValidationComplianceFederal RegulationsState RegulationsLocal Regulations
About the role
Key responsibilities & impact- Supports regular quality assurance (QA) audits of internal Coding Analyst Team to validate and confirm coding & abstracting quality.
- Tracks and reports progress of QA audits performed on the coding vendors to verify coding accuracy.
- Works with Risk Adjustment Management on any MRA data validation / coding audit.
- Analyzes and shares audit results with Manager for training and documentation improvement.
- Ensures compliance with all applicable federal, state & local regulations.
Requirements
What you’ll need- Minimum three years of Medicare Risk Adjustment coding in a medical group or health plan setting required
- High School Diploma or GED
- Completion of a Medical Coding training program
- Certified Coder required: CCS, CCS-P, CPC, CRC, RHIT or RHIA
- Proficient user in MS office suite – Excel, Word, Outlook
- Previous use of Epic, Allscripts, EZCap, Athenahealth
Benefits
Comp & perks- Health insurance
- Retirement plans
- Professional development
- Flexible work arrangements