Supervisor, Risk Adjustment Coding & Auditing - Remote

Overview

The Clinical Audit Supervisor oversees a team of clinical auditors who review, analyze, and audit documentation from medical records that drives clients’ risk adjusted capitated payments, ensuring compliance and accuracy in coding.

In Short

• Supervise a team of clinical auditors
• Conduct clinical validation audits
• Ensure accurate coding based on CMS guidelines
• Compile detailed findings and prepare reports
• Coordinate with clients for audit data
• Provide mentoring and guidance to the audit team
• Maintain professional certifications and licenses
• Stay updated on coding regulations and trends
• Participate in department meetings and process improvements
• Ensure compliance with HIPAA regulations

Requirements

• Associate degree or nursing program graduate
• Valid RN license required
• Certified coding credentials (CRN-C, CCS, CPC, CRC, RHIA, RHIT)
• Experience in Hierarchical Condition Categories (HCC)
• Knowledge of Medicare Advantage plans
• Proficient in MS Office applications
• Strong verbal and written communication skills
• Detail-oriented with the ability to work independently
• Experience in managed healthcare systems preferred
• Ability to handle confidential information

Benefits

• Comprehensive medical/dental/vision coverage
• Flexible spending accounts
• Company-paid life insurance and short-term disability
• Voluntary benefits
• 401(k) plan
• Paid Time Off and holidays
• Professional development opportunities
• Supportive work environment
• Equal opportunity employer
• Drug-free workplace