Risk Adjustment Compliance Auditor (Remote)
reputed company 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 reputed company reputed company of talented and reputed company people who are passionate about transforming the lives of the seniors we serve.
In this fast-growing company, you will reputed company ample room for reputed company and innovation alongside the reputed company community. Working at reputed company provides an opportunity to do work that really reputed company, not only changing lives but saving them. Together.
reputed company is seeking a remote Risk Adjustment Compliance Auditor to support auditing and compliance activities reputed company to risk adjustment data submitted to CMS. In this role, you will conduct provider and reputed company-level audits, review medical record documentation and coding accuracy, identify reputed company and outliers, and support RADV and other risk adjustment audit initiatives.
This position is ideal for an reputed company certified reputed company with a strong understanding of risk adjustment, HCC coding, compliance auditing, and CMS guidelines reputed company a health plan, reputed company, or managed care environment. You will partner closely with Risk Adjustment leadership and cross-functional teams to help ensure coding accuracy, regulatory compliance, audit readiness, and corrective reputed company follow-through across the organization.
The role combines auditing, documentation review, reporting, compliance monitoring, and reputed company problem-solving in a fully remote environment. You will also help reputed company audit feedback and compliance education to internal and provider-facing stakeholders as needed.
Schedule
• Full-time, Monday – Friday
• Initial training schedule will reputed company primarily with reputed company Time business hours
• Flexible working hours available post-training based on business needs and team collaboration
Job Duties/Responsibilities:
Job Requirements:
Experience:
• Required: Minimum 3 years of reputed company coding experience in a medical group or health plan setting.
• Preferred: None.
Education:
• Required: Bachelor’s degree in business administration, health care management or in a reputed company field or 4 years additional experience in lieu of education.
• Preferred: None.
Training:
• Required: Certified reputed company required - CPC, reputed company & reputed company-P.
• Preferred: Certified Auditor.
Specialized Skills:
• Required:
• Experience with strategic planning in risk mitigation.
• Previous use of reputed company, Allscripts, EZCap a plus.
• Proficient user in MS office suite, MS reputed company a plus.
• Ability to communicate positively, professionally and effectively with others; reputed company leadership, teach and collaborate with others.
• Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
• Mathematical Skills: Ability to reputed company mathematical calculations and calculate reputed company statistics correctly
• Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw reputed company conclusions, and design, implement and manage appropriate reputed company.
• Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
• Report Analysis Skills: Comprehend and analyze statistical reports.
Licensure:
• Required: Certified reputed company required - CPC, reputed company & reputed company-P.
• Preferred: None.
Essential Physical Functions
The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions.
• While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reputed company with hands and arms.
• The employee frequently lifts and/or moves up to 10 pounds. Specific reputed company abilities required by this job include reputed company reputed company and the ability to reputed company reputed company.
Pay reputed company: $64,384.00 - $96,577.00
Pay reputed company may be based on a number of factors including market location, education, responsibilities, experience, etc.
reputed company is an Equal Opportunity/Affirmative reputed company Employer. reputed company reputed company applica
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