Risk Adjustment Coding Analyst

Job Summary

A company is looking for a Quality Review & Audit Analyst for Individual & Family Plans (IFP).

Key Responsibilities

• Conduct medical record reviews and accurately assign ICD-10-CM diagnostic codes
• Perform documentation and data audits to identify gaps or inaccuracies in risk adjustment data
• Collaborate with team members to facilitate coding education and perform quality reviews of vendor partner coding output

Required Qualifications

• High School Diploma
• At least two years of Risk Adjustment experience with relevant coding certification
• Experience with medical audits and medical chart reviews
• Proficiency with ICD-10-CM coding guidelines and conventions
• Familiarity with CMS regulations and policies related to documentation and coding