Risk Adjustment Coding Auditor II (Remote) - R7331

Job Summary

The Risk Adjustment Coding Auditor II is responsible for performing over-reads of vendor ICD-10 coding, reviewing provider documentation supplied to them, and diagnostic codes assigned by vendor. This job is full-time, remote.

Essential Functions

Meets assigned volume metricsValidates the accurateness of ICD-10 codes assigned by the vendorTracks the trends and reports on the findingsDemonstrates a thorough understanding of Risk Adjustment hierarchical condition categories (HCCs), for all risk adjusted productsParticipates in quality coding initiatives as appropriate or assignedMaintains knowledge of AHA Coding Clinic and ICD-10 Official Guidelines for Coding and ReportingMay be asked to perform over reads of provider coding/documentationMeets deadlines and works independently on multiple projectsPerform any other job duties as requested

Education And Experience

High School Diploma or GED is requiredMinimum of three (3) years of diagnostic coding experience and a firm understanding of ICD-10 is requiredA minimum of three (3) years of experience in auditing medical records is requiredRisk Adjustment methodology experience required

Competencies, Knowledge And Skills

Intermediate level with Microsoft Word, Microsoft Outlook, Microsoft ExcelAbility to work in a fast paced production environment while maintaining high qualityKnowledgeable and experienced with researching CMS and other sites for Risk Adjustment guidanceExceptional knowledge of medical coding and regulatory requirementsKnowledgeable of Medicaid, Medicare, ExchangeKnowledgeable of ICD-10Ability to make independent decisions on ICD 10 code assignmentsExcellent verbal and written communication skillsAbility to effectively interface with teammates, vendors and managementAbility to work with others and work independentlyPossesses critical thinking/listening skillsStrong interpersonal skills and high level or professionalismDetail orientedFacets training/knowledge is preferred

Licensure And Certification

AAPC or AHIMA coding certification is required

Working Conditions

General office environment; may be required to sit or stand for extended periods of time

Compensation Range

$52,400.00 - $83,900.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type

Hourly