HCC Coding Auditor (Certified)

Job Summary

To ensure the accuracy of HCC coded records, the full-time remote HCC Coding Quality Specialist (Auditor) will review coding compliance with Medicare and ICD-10-CM guidelines, support coder education on findings, and maintain a quality score of 95% or higher.

Key responsibilities:

• Review HCC coded records for compliance with Medicare and ICD-10-CM guidelines
• Support coders by clearly identifying errors and providing educational feedback
• Assist in creating training materials and presentations for the HCC coding team

Required qualifications:

• Certification through AAPC or AHIMA (CPC, CRC, CCS, or CCS-P) is mandatory
• At least 3 years of HCC coding experience and 2 years of auditing experience
• Global experience in HCC auditing is preferred
• Working knowledge of EMRs, billing systems, and abstraction platforms
• Ability to maintain compliance with privacy and security regulations