Coding Quality Auditor – Revenue Capture

This is a fully remote position, open to applicants in Washington.

📋 Description

• Perform thorough diagnostic chart reviews of clinical documentation and coding related to Risk Adjustment and HCC coding.

• Evaluate and abstract HCC codes to guarantee accurate coding at the highest level of specificity.

• Engage with providers to clinically validate or clarify diagnosis criteria.

• Assess documentation for compliance, resulting in proper reporting/billing and RVU capture.

⛳️ Requirements

• Within one year of hire: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).

• Minimum of 2 years of experience in medical insurance reimbursement, medical billing, and coding related to charge review and work RVUs.

• Proficient in reviewing patient account information, insurance explanation of benefits, computer screens, and financial documentation.

• Preferred: Bachelor's Degree or equivalent education/experience.

• Within one year of hire: Certified Risk Adjustment Coder (CRC).

• Within one year of hire: Certified Professional Medical Auditor (CPMA) or Certified Healthcare Compliance Auditor (CHCA).

• Experience in HCC coding.

🏝️ Benefits

• Comprehensive benefits package that includes healthcare benefits (medical, dental, vision).

• 401(k) Savings Plan with employer matching.

• Life insurance.

• Disability insurance.

• Time off benefits (paid parental leave, vacations, holidays, health issues).

• Voluntary benefits.

• Well-being resources.