Risk Adjustment Coding Oversight Specialist - Remote

Overview

The Risk Adjustment Coding Oversight Specialist is responsible for conducting vendor oversight and quality assurance audits for risk adjustment purposes, ensuring accurate and complete coding.

In Short

• Conduct quality oversight audits for risk adjustment coding.
• Report added or deleted diagnosis based on medical record reviews.
• Report QA findings and trends to senior specialists or managers.
• Support departmental goals and vendor SLA requirements.
• Facilitate effective interventions for coding accuracy.
• Minimum of two years experience in medical record review.
• CPC or AHIMA CCS credential required.
• Ability to work well in a team environment.
• Experience with Medicare and/or Commercial risk adjustment processes.
• Understanding of electronic medical and health records.

Requirements

• High-school Diploma or equivalent.
• Current CPC or AHIMA CCS certification.
• Current CRC certification.
• Two years recent experience in diagnosis coding.
• Ability to meet attendance and timeliness requirements.
• Strong communication skills and attention to detail.
• Flexibility to manage multiple demands.
• Teamwork and relationship-building skills.
• Reasonable accommodations for individuals with disabilities.
• Other duties as assigned.

Benefits

• Opportunities for personal and professional growth.
• Supportive work environment.
• Mission-driven organization focused on community health.
• Diversity of experience and perspective valued.
• Innovative healthcare solutions.