Risk Adjustment Compliance Auditor

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

📋 Description

• Perform audits at the provider and coder levels, assessing medical record documentation and the accuracy of coding.

• Detect compliance risks and anomalies, while assisting with RADV and other risk adjustment audit efforts.

• Collaborate closely with Risk Adjustment leadership and various cross-functional teams.

• Ensure the accuracy of coding, adherence to regulations, preparedness for audits, and implementation of corrective actions throughout the organization.

• Deliver audit feedback and compliance training to both internal stakeholders and providers as necessary.

⛳️ Requirements

• At least 3 years of professional coding experience within a medical group or health plan environment.

• A Bachelor’s degree in business administration, healthcare management, or a related field, or 4 additional years of experience in lieu of a degree.

• Certification as a Coder is required - CPC, CCS & CCS-P.

• Experience in strategic planning for risk mitigation; familiarity with Epic, Allscripts, and EZCap is advantageous.

• Proficient in the Microsoft Office suite, with knowledge of MS Access being a plus.

🏝️ Benefits

• Health insurance

• Flexible working hours

• Professional development opportunities