QHP Coding Auditor

Job Summary

A company is looking for a QHP Coding Auditor (REMOTE).

Key Responsibilities

• Conduct initial chart reviews and coding quality audits to validate ICD-10-CM code accuracy
• Abstract and audit codes for QHP (RADV) projects, ensuring documentation supports coding decisions
• Apply state, federal, and CMS documentation requirements consistently across all assignments

Required Qualifications

• Active AHIMA or AAPC certification (e.g., RHIT, CCS, CCS-P, CPC, CIC); CRC strongly preferred
• Minimum 7 years of coding experience, including 5+ years in Risk Adjustment (RADV experience required)
• Proficiency with Microsoft Office Suite and coding software or encoders
• Must have a secure, private workspace compliant with PHI confidentiality standards