Job Description Title: Coding Auditor
Location: Remote
Job Type: Contract (4 Months)
Compensation: $30.00-35.00/hr
Industry: Health Insurance
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About the Role We are partnering with a leading, mission-driven health insurance organization serving Commercial, Medicare, and Medicaid populations across the region. Our client is committed to advancing high-quality care, regulatory compliance, and accurate risk adjustment methodologies.
As a Coding Auditor, you will support enterprise-wide risk adjustment initiatives through high-quality coding audits, compliance-focused documentation reviews, and participation in regulatory audit activities. This role is ideal for an experienced medical coder with a strong understanding of HCCs, risk models, and audit processes.
Job Description In this position, you will provide quality assurance and coding audit services to support risk adjustment across ACA Commercial, Medicare, and Medicaid programs. You will evaluate provider documentation, validate coding accuracy, and ensure compliance with current federal, state, and industry standards.
Key Responsibilities include: - Serving as an experienced coder participating in regulatory audits, including RADV and HRADV.
- Reviewing patient records in alignment with current compliance policies to ensure provider documentation supports all diagnosis and procedure codes, including medical necessity, severity of illness, and risk of mortality.
- Conducting audits on abstracted files to validate the accuracy and completeness of ICD-CM (ICD-9/ICD-10) and CPT-4 coding, ensuring adherence to official guidelines and organizational policies.
- Demonstrating a strong understanding of hierarchical condition categories (HCCs) and contributing to quality-coding initiatives.
- Clearly communicating coding findings to internal and external stakeholders.
Qualifications Required Qualifications: - Associate degree and 3 years of RADV (Risk Adjustment Data Validation) experience; or 5 years of relevant experience in lieu of degree.
- Proficient knowledge of the CMS-HCC model and associated guidelines.
- Previous experience auditing medical records.
- Active coding certification in good standing (CRC, RHIA, RHIT, or similar).
- Proficiency in ICD-10 coding.
Preferred Qualifications: - Bachelor's degree.
- Experience using NLP/AI-driven coding tools.
- Background in risk adjustment methodologies.
- Specialty coding experience.
Benefits Dahl Consulting is proud to offer a comprehensive benefits package to eligible employees that will allow you to choose the best coverage to meet your family's needs. For details, please review the DAHL Benefits Summary: https://www.dahlconsulting.com/benefits-w2fta/.
How to Apply Take the first step on your new career path!To submit yourself for consideration for this role, simply click the apply button and complete our mobile-friendly online application. Once we've reviewed your application details, a recruiter will reach out to you with next steps!
Equal Opportunity Statement As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply. If this position sounds like the right opportunity for you, we encourage you to take the next step and connect with us. We look forward to meeting you!
Dahl Consulting is proud to offer a comprehensive benefits package to eligible contract employees that will allow you to choose the best coverage to meet your family's needs. For details, please review our Benefits Summary: www.dahlconsulting.com/benefits-w2fta.
Dahl Consulting is an Equal Opportunity Employer and does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other applicable legally protected characteristics.
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