Certified Risk Adjustment Auditor
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Job Summary
Ensuring the accuracy and compliance of coded clinical data, the remote contract Certified Risk Adjustment Auditor will conduct chart reviews, audit diagnosis codes, and provide feedback to improve coding practices within a healthcare setting.
Key responsibilities
- Conduct retrospective and prospective chart reviews to validate risk adjustment coding accuracy and completeness
- Audit provider-reported diagnosis codes for compliance with coding guidelines and regulatory requirements
- Identify coding and documentation deficiencies and provide feedback to stakeholders
Required qualifications
- High school diploma, GED, or equivalent practical experience
- 7+ years of professional experience in risk adjustment, medical coding, auditing, or a related healthcare field
- 5+ years of Hierarchical Condition Category (HCC) coding experience
- Certified Risk Coder (CRC) certification in good standing or ability to obtain certification within six months of hire
- Experience interpreting and applying coding policies, regulations, and documentation standards
Complete Job Description
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