Auditor, Risk Adjustment

📋 Description

• Audit ICD-10-CM coding for ACA/MA and perform quality audits.
• Validate provider documentation supports EDGE data and coding.
• Monitor audit trends and report to leadership to drive improvements.
• Maintain compliance with ICD-10-CM guidelines and risk adjustment standards.
• Perform CMS audits and RADV activities to verify risk adjustment.
• Develop CDI resources to educate providers in MA/ACA.

🎯 Requirements

• Bachelor's degree or commensurate work experience.
• Certified Professional Coder (CPC).
• 3+ years retrospective risk adjustment coding experience.
• 1+ year experience in Quality Auditing and/or RADV.

🎁 Benefits

• Medical, dental, and vision benefits.
• 11 paid holidays, paid sick time, and parental leave.
• 401(k) plan with life and disability insurance.
• Unlimited vacation and annual performance bonuses.