Oregon Licensed Risk Adjustment Auditor

Job Summary

A company is looking for a Risk Adjustment Auditor (Remote).

Key Responsibilities

• Conduct retrospective and prospective medical chart reviews to support accurate risk adjustment reporting
• Validate diagnosis coding accuracy, completeness, and specificity in alignment with documentation standards and CMS HCC requirements
• Identify trends in provider coding and documentation and collaborate with partners to support targeted improvement strategies

Required Qualifications

• Active CRC (Certified Risk Adjustment Coder) and CPC (Certified Professional Coder) certifications (both required)
• Advanced knowledge of risk adjustment principles, diagnosis coding, and documentation standards
• Proven experience performing detailed chart reviews with a high degree of accuracy and consistency
• Proficiency with standard business software and the ability to adapt to changing priorities