Certified Risk Adjustment Auditor

Job Summary

Responsible for auditing and validating medical coding and documentation for risk adjustment, the full-time Certified Risk Adjustment Auditor will conduct compliance audits, review medical records, and ensure accurate ICD-10 coding while working remotely.

Key responsibilities:

• Conduct coding and documentation audits of medical records to ensure compliance with risk adjustment standards
• Review patient medical records to identify relevant diagnoses and assign appropriate ICD-10 codes
• Stay updated on coding guidelines and compliance standards to maintain accuracy in the coding process

Required qualifications:

• Associates degree or equivalent relevant education and experience
• 5+ years of clinical coding experience, specifically in risk adjustment coding
• Certification as a Certified Coder (CPC/COC) or Certified Risk Coder (CRC) required
• Proficient understanding of ICD-9/10 CM, CPT, and other coding guidelines
• Strong knowledge of medical terminology and chronic disease management