Risk Adjustment QA Specialist

Job Summary

A company is looking for a Risk Adjustment QA Specialist to ensure accurate and compliant documentation through chart audits and provider education.

Key Responsibilities

• Conduct chart audits and provide feedback on documentation errors and missed HCC opportunities
• Identify training opportunities for documentation and HCC coding
• Prepare audit finding reports and monitor corrective actions for compliance issues

Required Qualifications

• High School Diploma or equivalent; Bachelor's degree preferred
• 5+ years of experience in healthcare related to HCC Risk Adjustment and/or chart auditing
• Current AAPC or AHIMA certification (e.g., CCS, CPC, RHIT)
• Strong understanding of CMS Risk Adjustment guidelines and ICD coding
• Proficiency with Microsoft Word, Excel, and Outlook