Quality Assurance Coder

Job Title: Quality Assurance Coder/Auditor
Location: Phoenix, AZ (1 day/week onsite) (Hybrid)
Duration: Long-Term Contract

Job Summary:
We are seeking a Quality Assurance Coder/Auditor with strong HCC and ICD-10 coding experience to review medical records, ensure accurate risk adjustment coding, perform quality audits, and provide coding education to healthcare providers. This role supports compliance with CMS guidelines and helps improve documentation accuracy and risk mitigation.

Key Responsibilities:

• Review and audit medical records for accurate ICD-10/HCC coding.
• Ensure compliance with CMS Medicare Risk Adjustment guidelines.
• Perform quality assurance audits and provide coding feedback.
• Educate providers on documentation and coding best practices.
• Analyze coding trends and recommend process improvements.
• Track audit results and prepare monthly QA reports.

Required Qualifications:

• Strong knowledge of ICD-10, HCC Coding, and CMS Risk Adjustment.
• Experience with medical record auditing and provider education.
• Understanding of Medicare Managed Care and documentation requirements.
• Proficiency in Microsoft Office (Word, Excel, PowerPoint).
• Excellent communication and analytical skills.

Preferred:

• Experience with RADV audits and risk adjustment validation.
• CPC, CRC, CCS, or equivalent coding certification preferred.