Coding Data Quality Auditor

• Performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes for compliance with risk adjustment processes
• Supporting coding judgment and decisions using industry standard evidence and tools
• Abstraction and assignment of accurate medical codes as documented by physicians and other healthcare providers
• Ensuring compliance with coding guidelines and regulations to establish medical necessity
• Identifying clinically active vs. historical conditions
• Ensuring diagnosis codes are appropriate, accurate, and supported by clinical documentation
• Utilizing medical records for etiology and disease manifestation documentation
• Following project deadlines and directives
• Conducting self-audits to ensure compliance with internal policies and regulations.

• Minimum of 1 year recent and related experience in medical record documentation review, diagnosis coding, and/or auditing
• CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) required
• CRC (Certified Risk Adjustment Coder)
• Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications)
• Experience with International Classification of Disease (ICD) codes required
• Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) preferred.

Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC).

• Affordable medical plan options
• 401(k) plan with matching company contributions
• Employee stock purchase plan
• No-cost programs including wellness screenings, tobacco cessation, and weight management programs
• Confidential counseling
• Financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access.