Coding Auditor

Retrieved 11 days ago from Remote

Coding Auditor (Risk Adjustment-Medicare/Medicaid/Commercial)

Location: Remote, US-Based
Job Type: Contract, Full-Time

Company Description

Centauri Health Solutions delivers software that helps to improve access to healthcare and healthcare technology. We aim to attract and retain the industry’s top talent as we continue to create innovative software and deliver flexible solutions for health plans, providers, hospitals and care managers.

We are a provider of eligibility enrollment services, data-driven services, and data management software solutions designed specifically for risk adjustment and quality-based revenue programs. Centauri makes a real difference in the lives and work of those who count on healthcare technology. Patients gain access to healthcare and our clients gain actionable, accurate and timely information about the quality of care those patients receive.

We are growing at a rapid pace as we continuously provide our clients with better visibility into the key interaction driving the healthcare cycle a member’s encounter with his or her provider of care. We work to deliver advanced end-to-end solutions for our clients, to maximize the transparency of that interaction, along with the impact of the encounter on the overall healthcare cycle.

Centauri will continue to grow with talented individuals who understand the importance of being committed to our philosophy. Please contact us if you are interested in growing with our team.

Centauri Health Solutions is an equal opportunity employer.

Job Description

Conduct coding quality audits on internal and external coders to ensure diagnoses are appropriately and accurately assigned based upon written clinical documentation, Official Coding Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. Apply guidance provided for the audit of the following programs; including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA (Initial Validation Audit), and Medicare RADV (Risk Adjustment Data Validation).

Responsibilities

  • Perform audits of medical records to ensure ICD-9-CM/ICD-10-CM codes are accurately assigned and supported by clinical documentation
  • Provide formal report(s) on audit findings and conduct education to internal and external coders based upon those findings
  • Assist coding leadership by making recommendations for process improvements to further enhance coding quality goals and outcomes
  • Maintain current knowledge of ICD-9-CM/ICD-10-CM codes, CMS documentation requirements, and state and federal regulations
  • Performs other related duties as required or assigned

Qualifications

  • Current core coding credential through AHIMA or AAPC (RHIT, CCS, CCS-P, CPC, CIC, etc.) and AAPC CRC (Certificated Risk Adjustment Coder) coding certification are both required
  • Minimum of 5 years of hands on coding experience in the Risk Adjustment environment
  • Advanced Excel skills
  • Technically savvy with Microsoft Office applications
  • Strong written and verbal communication skills

Centauri was founded to constantly create unique, innovative tools within the marketplace. Tools that allow our clients to improve lives. We will continue to grow with talented individuals who understand the importance of being committed to our philosophy. If you are interested in learning more about how you can grow with Centauri, we’d like you to contact us. Send your resume to jobs@centaurihs.com.

Centauri Health Solutions is an equal opportunity employer.

Apply Instructions