Risk Adjustment Auditor

Job Summary

A company is looking for a Risk Adjustment Auditor.

Key Responsibilities

• Audit medical records and Medicare claims for coding accuracy and compliance with CMS guidelines
• Assign and validate diagnosis codes based on qualified medical documentation
• Escalate discrepancies and assist with workflow management among fellow coders

Required Qualifications

• Relevant credential from AAPC or AHIMA; CMPA preferred but not required
• 5 years of medical coding experience; inpatient coding experience preferred but not required
• Must pass Medicare IRR review with 95% accuracy upon hire
• Ability to work in a performance-driven environment and meet productivity standards
• Technical skills to navigate various software systems and work efficiently in a virtual environment