POSITION: HCC Risk Adjustment Coding Auditor
DEPARTMENT: Health Information Services
JOB DESCRIPTION: The Coder Quality Specialist conducts 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-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The Coder Quality Specialist applies 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).
- Perform audits of coded medical records to ensure 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-10-CM codes, CMS documentation requirements, and state and federal regulations
- Consistently maintain a minimum 95% accuracy rate on audits by coding leadership
- Meet minimum productivity requirements as outlined by the project terms
- Performs other related duties as required or assigned
- Minimum of 3 years of hands-on coding experience in the Risk Adjustment environment.
- Minimum of 2 years of experience conducting coder audits in the Risk Adjustment environment.
- 5+ year CRC Coding Certification through AAPC as well as a coding certification through AHIMA or AAPC (RHIT, CCS, CCS-P, CIC, etc.). NO CCA or CPC-A certifications will be accepted
- Strong Excel skills (advanced level)
- Technically savvy with Microsoft Office applications
- Strong written and verbal communication skills
- Ability to work independently in a remote environment
- High School Diploma
- Completion of an accredited medical coding program is highly desired, but not required
Working Hours Needed:
• Monday - Sunday 8hrs per day, 40hrs a week, must work between 6a-10p CT.
• Flexible hours
Compensation & Benefits:
• Pay: Hourly and on a weekly basis
• Health & Dental
• PTO, Sick Time, 6 paid holidays
• 401K, HAS
• Weekly Pay
AMN Healthcare Revenue Cycle Solutions:
LET'S DO THIS!! If you want to join a WINNING CULTURE where you can grow your craft, than look no further! We have been placing Revenue Cycle candidates for more than a decade. Let us help you get you to the next level! Apply today and one of our team members will be in touch to help you find the role that best fits your skills and goals!
Becoming an AMN Healthcare nurse gives you the incredible opportunity to explore new cities, gain critical nursing career experience, and earn a highly competitive salary-but the perks don't stop there. There are many additional benefits to enjoy through travel nursing jobs, including:
- Premium health benefits for you and your family
- Access to the largest network of facilities and providers in the country
- Industry-leading clinical team support
- Licensure assistance
- 401k matching
- Free CEUs
About the Company
At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.
With its luxurious resorts, pampering spas, vibrant arts scene and year-round perfect weather, Scottsdale beckons travel nurses from near and far. Located in the heart of the beautiful Sonoran Desert, this is the place to soak up the sun, indulge in marathon shopping excursions and to savor stunning sunsets and breathtaking scenic vistas.