Risk Adjustment Auditor
Franciscan Health
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $19 - $29 per hour
About the role
- Review medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries.
- Assist with validation audits to evaluate medical record documentation, to ensure coding accurately reflects and supports relevant coding based on the ICD-10 code.
- Submit documentation to CMS for reimbursement and interpretation of medical documentation, to ensure capture of all relevant coding based on CMS Hierarchical Condition Categories (HCC) conditions that are applicable to Medicare Risk Adjustment reimbursement initiatives.
- Attention to detail while reviewing patient’s clinical record.
- Ensure regulatory compliance, and overall quality and efficiency by utilizing strong working knowledge of coding standards and EPIC.
Requirements
- Associate's Degree, LPN/RN - Associates Degree - Required or Certificate, Medical Assisting - Required
- 3 years experience in the Medical Field - Required
- 1 year Coding experience - Preferred
- Certified Medical Assistant (CMA) - American Association of Medical Assistants (AAMA) - Required or Licensed Practical Nurse (LPN) - State Licensing Board - Required or Registered Nurse (RN) - State Licensing Board - Required
Benefits
- Comprehensive benefit offerings
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
ICD-10 codingmedical record documentationcoding standardsvalidation auditsreimbursement documentationCMS Hierarchical Condition CategoriesMedicare Risk Adjustmentattention to detailclinical record reviewcoding experience
Soft Skills
attention to detailorganizational skillscommunication skills
Certifications
Certified Medical Assistant (CMA)Licensed Practical Nurse (LPN)Registered Nurse (RN)