Certified Risk Adjustment Coder

Job Summary

Supporting departmental Quality Assessment audits, the full-time Certified Risk Adjustment Coder will manage coding accuracy and data integrity for Medicare Risk Adjustment, working remotely to enhance performance standards and compliance.

Key responsibilities

• Conduct regular quality assurance audits of internal Coding Analyst teams to ensure coding quality and performance improvement
• Track and report on coding vendor audits to verify accuracy and quality of data submitted to CMS
• Collaborate 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, with completion of a Medical Coding training program
• Certified Coder required (CCS, CCS-P, CPC, or CRC)
• Proficient in MS Office Suite, with experience using Epic, Allscripts, or EZCap
• Ability to analyze statistical reports and perform mathematical calculations accurately