2 hcc risk adjustment coding auditor jobs found

Risk Adjustment Coding Auditor Location: Remote (U.S.) Employment Type: Contract-to-Hire About the Role The Risk Adjustment Coding Auditor is responsible for ensuring the accuracy, completeness, and compliance of diagnosis coding used in risk adjustment programs. This role conducts prospective and retrospective chart audits, validates diagnosis code capture, identifies documentation opportunities, and provides coding guidance to support regulatory compliance and appropriate reimbursement. The auditor serves as a subject matter expert in risk adjustment coding and works closely with internal teams to maintain data integrity and reduce financial and regulatory risk. Key Responsibilities Perform prospective and retrospective medical record reviews and audits. Validate diagnosis code accuracy, completeness, specificity, and appropriateness based on provider documentation. Review medical records to ensure proper capture of CMS-HCC diagnoses and risk adjustment...

Job Description Job Description Join Senior CommUnity Care as a Medical Coder - Risk Adjustment Specialist and partner directly with physicians and Medical Directors to improve documentation, support CMS reporting, and strengthen value-based care for older adults in the PACE program. Medical Coder - Risk Adjustment Specialist- Remote Schedule: M-F 8:00 AM-5:00 PM Salary: $58,000-$66,000 (Based on Experience) Essentials: Collaboration for Risk Adjustment Integrity: Works closely with Medical Directors and PACE providers to uphold the integrity and accuracy of the risk adjustment reporting process. Engages in continuous dialogue with healthcare professionals to ensure that coding accurately reflects participant acuity. Medication Documentation Review and Diagnostic Coding: Reviews and interprets provider documentation to extract critical information. Assigns ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures from documented information in the medical...