Certified Medicare Coding Auditor

Job Summary

Supporting quality assessment audits, the full-time Certified Medicare Coding Auditor will work remotely to ensure accurate data submission to CMS, assist in risk adjustment data audits, and analyze audit results for process improvement.

Key responsibilities

• Conducts regular quality assurance audits of the internal Coding Analyst Team to validate coding accuracy and quality
• Tracks and reports progress of audits on coding vendors to ensure data accuracy for CMS submissions
• Collaborates with Risk Adjustment Management on data validation and coding audits to ensure completeness and accuracy of submissions

Required qualifications

• Minimum three years of Medicare Risk Adjustment coding experience in a medical group or health plan setting
• High School Diploma or GED; completion of a Medical Coding training program
• Certified Coder (CCS, CCS-P, CPC, CRC, RHIT, or RHIA) required
• Proficient in MS Office Suite and previous use of electronic health record systems such as Epic or Allscripts
• Technical courses required for certification as a coder