3 specialized coder jobs found

Become a part of our caring community The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Reviews medical records to report conditions that map to HCCs by reviewing medical record documentation and applying the appropriate ICD-10 diagnosis codes. Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records. Works on projects that may include making phone calls to providers. Works within broad guidelines with...

Company Overview Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast‑growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Job Summary Alignment Health is seeking a remote Risk Adjustment Compliance Auditor to support auditing and compliance activities related to risk adjustment data submitted to CMS. In this role, you will conduct provider and coder‑level audits, review medical record documentation and coding accuracy, identify compliance risks and...

Alignment Health is a remote company focused on senior care. The Medical Risk Adjustment (MRA) Coding Auditor role supports departmental quality assessment audits of internal coding analysts and vendors to ensure accurate and complete data submission to CMS. General Duties / Responsibilities Supports regular quality assurance audits of the internal Coding Analyst Team to validate and confirm coding & abstracting quality (95% HCC accuracy), ensuring coding quality and performance improvement standards are maintained. Tracks and reports progress of QA audits performed on coding vendors to verify coding accuracy and quality of data submitted to AHP for CMS submission. Works with Risk Adjustment Management on any MRA data validation or coding audit to ensure completeness and coding accuracy of all CMS submissions; this may include data reconciliation, data flow integrity, UAT testing, review of high‑cost/low‑risk score members, retrospective chart reviews, or other related data...