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Risk Adjustment Coding Analyst
Job Summary
A company is looking for an Individual & Family Plans (IFP) Quality Review and Audit Analyst.
Key Responsibilities
- Conduct medical record reviews and assign ICD-10-CM diagnostic codes accurately
- Perform documentation and data audits to identify gaps or inaccuracies in risk adjustment data
- Collaborate with team members and external partners for coding education and quality reviews
Required Qualifications
- High School Diploma
- At least two years of Risk Adjustment experience with relevant certification (CPC, CCS-P, CCS-H, RHIT, RHIA, or CRC)
- Achieve CRC certification within 6 months of hire, if not currently certified
- Experience with medical audits and medical chart reviews
- Proficiency with ICD-10-CM coding guidelines and conventions
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COMPLETE JOB DESCRIPTION
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