Risk Adjustment Coding Auditor

Job not on LinkedIn

🔥 58 minutes ago

🌲 Oregon – Remote

🌲 Oregon – Remote

💵 $32 - $37 / hour

⏳ Contract/Temporary

🟠 Senior

🔴 Lead

🔎 Auditor

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TEKsystems

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1983

💼 Consulting

🎯 Recruiter

🏢 Enterprise

Consulting • Recruitment • Enterprise

TEKsystems is a global IT and business services firm that provides technology consulting, talent solutions, managed services and workforce recruitment to enterprise clients. The company delivers cloud, digital and data services (including AI/ML and automation), application innovation, Agile/DevOps transformation, technology operations and digital experience work, and operates large-scale talent and managed service programs. TEKsystems works across industries (financial services, healthcare, public sector, telecommunications, retail/manufacturing, energy and more), maintains technology partnerships with major cloud and software providers, and reports more than $7B in annual revenue and 100+ locations worldwide.

📋 Description

• Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices • Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements • Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting • Verifies and ensures the accuracy, completeness, specificity and appropriateness of provider‑reported diagnosis codes based on medical record documentation • Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories • Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with requirements • Contributes to audit and production efforts to meet business demand and workload priorities • Provide written and verbal guidance on coding errors to others • Meets audit deliverables within established timelines and deadlines • Assists with special projects such as risk mitigation reviews • Serves as subject matter resource regarding the risk adjustment process and diagnosis coding for risk adjustment

🎯 Requirements

• 7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered. • 5+ years of HCC coding experience in utilizing inpatient and outpatient coding guidelines • 5+ years of experience auditing Risk Adjustment records • 1+ years working in a Production environment • CRC (Certified Risk Coder) in good standing • Intermediate level of knowledge in risk adjustment Medicare, ACA Commercial and Medicaid models • Demonstrated ability to apply critical thinking skills to coding policy interpretation and implementation. • Experience providing written and verbal guidance on coding errors and trends • Intermediate (or higher) MS Office (Word, Excel, Powerpoint & Outlook) • Excellent organizational ability to manage multiple projects and perform in a deadline driven environment • High school diploma (or equivalency) and legal authorization to work in the U.S.

🏖️ Benefits

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)