Senior Risk Adjustment Coding Auditor
CareOregon
full-time
Posted on:
Location Type: Remote
Location: Idaho • Oregon • United States
Visit company websiteExplore more
Salary
💰 $81,000 - $99,000 per year
Job Level
About the role
- Perform and lead a variety of coding-related audits for providers and other entities
- Review medical records to verify that complete and accurate diagnosis codes are captured in claims and retrospective chart review data
- Communicate audit results and recommendations for improvement to providers when needed
- Create and maintain processes for tracking audit results and outcomes of reviews
- Identify, track, analyze and report on any trends revealed in audits
- Develop and maintain centralized policy, process and compliance-related documentation and training resources to support the education of providers and internal stakeholders
- Lead the development of educational materials and process documentation in a variety of mediums
- Actively maintain up-to-date knowledge of coding guidelines and applicable state and federal regulations
- Maintain active coding certification
- Seek out emerging coding best practices
- Serve as subject matter expert regarding correct coding practices
- Collaborate with Risk Adjustment team to create SOPs and contribute to roadmaps for Risk Adjustment Coding initiatives
- Onboard and train new Coding Auditors
Requirements
- Minimum 5 years’ experience as a certified coder
- Current coding certification from AHIMA or AAPC
- One-year experience with risk adjustment program in a Health Plan
- Certified Risk Adjustment Coder (CRC), Certified Documentation Improvement Practitioner (CDIP) or Certified Documentation Expert Inpatient or Outpatient (CDEI or CDEO) preferred
- Experience leading group educational presentations and teaching to medical professionals
- 5 years’ experience with CMS, HHS and/or CDPS+RX Hierarchical Condition Categories (HCC) models
- Experience with or knowledge of risk adjustment principles
Benefits
- Health insurance
- Dental coverage
- Vision insurance
- Life insurance
- AD&D insurance
- Disability insurance
- Health savings account
- Flexible spending account(s)
- Lifestyle spending account
- Employee assistance program
- Wellness program
- Discounts and supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings)
- Retirement plan with employer contributions
- Paid time off (PTO) and Paid State Sick Time based on hours worked
- Paid holidays, volunteer time, jury duty, and bereavement leave
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
coding auditsdiagnosis codingchart reviewdata analysispolicy documentationprocess documentationcoding guidelinesrisk adjustment codingeducational material developmenttrend analysis
Soft Skills
communicationleadershipcollaborationtrainingpresentation skillssubject matter expertiseorganizational skillsproblem-solvinganalytical thinkingeducational support
Certifications
AHIMA certificationAAPC certificationCertified Risk Adjustment Coder (CRC)Certified Documentation Improvement Practitioner (CDIP)Certified Documentation Expert Inpatient (CDEI)Certified Documentation Expert Outpatient (CDEO)