Certified Risk Adjustment Coder

Job Summary

Evaluating complex medical documentation for diagnosis code accuracy, the full-time Quality Review and Audit Analyst will conduct audits, mentor junior team members, and ensure compliance with HHS' Risk Adjustment program while working remotely.

Key responsibilities

• Assign accurate ICD-10 diagnosis codes in accordance with coding guidelines and protocols
• Audit abstracted diagnostic codes for accuracy and compliance, providing feedback on quality standards
• Lead training for junior team members and contribute to the execution of Risk Adjustment programs

Required qualifications

• High School Diploma or equivalent; Bachelor's degree or equivalent experience preferred
• 5+ years of medical record coding experience with certification from AAPC or AHIMA, including Certified Risk Adjustment Coder (CRC)
• Willingness to achieve CRC certification within 12 months if not already certified
• Experience with Risk Adjustment coding and familiarity with CMS regulations
• Proficiency in MS Excel, MS Word, and Adobe Acrobat