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Remote Sr. Risk Adjustment Coding Auditor - Jacksonville, United States - The CSI Companies
Description
CSI Companies is immediately seeking a Remote Sr. Risk Adjustment Coding Auditor for a long- term consultant position.RISK ADJUSTMENT CODING AUDITOR JOB SUMMARY
Provides coding and coding auditing services.
This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes.
The Senior Risk Adjustment Coding Auditor is the last step of the coding process and ensures that valid Hierarchal Coding Conditions are being presented to our clients and to CMS.
Responsible for performing quality review audits of medical records coded by Risk Adjustment coding team to ensure the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures.
The What You Want to Know
100% REMOTE - Work from home
Schedule:
Training 8-5 central M-F
After training schedule can be between 6am-6pm Central
40 hours a week, full time hours
Hourly, weekly pay
Paid training
Long term consultant position - Benefits Offered
Free CEUs
Equipment and encoder provided.
Excellent training with worldwide reputable company.
Required Certification:
Active certified coder certification through AAPC required: CRC, CPC, CPMA (Certified Risk Adjustment Coder, Certified Professional Coder)
What you will be doing
Completes timely audits of assigned coders and coding auditors for accurate, complete, and compliant ICD-10-CM and HCC code assignment, ensuring that documentation supports the diagnoses reported.
Reviews audit findings with assigned coders and coding auditors, providing education on opportunities identified and offering objective supporting documentation (e.g., current coding conventions, regulatory/payor-specific requirements, risk-adjustment guidelines, organization-specific policies) to support findings.
Documents audit resultsImmediately reports adverse audit trends, potential areas of risk, and compliance concerns to leadership
Serves as coding compliance resource
Provides education to internal staff based on audit findings; provides general education on ICD-10 codes that map to HCCs and RxHCCs as appropriate
Effectively communicates the audit process and results to appropriate leaders
Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations
Identifies and recommends opportunities for process improvements so that productivity and quality goals can be met or exceeded and operational efficiency and final accuracy is achieved
Ability to work independently as well as in a cross functional role within other teams for collaboration on best practices
Adhere to stringent timelines consistent with project deadlines and directives
Monitors own work to help ensure quality
Leads dispute resolution
Provides education to internal staff based on audit findings; provides general education on ICD-10-CM codes as appropriate
Position Requirements:
Ability to work 40 hours a week. First 5 weeks will be M-F 8am-5pm Central (required)
Active coding certification from
AAPC :
CPC, CRC, and/or CPMA
Minimum of 3 years of recent Risk Adjustment Coding
Minimum of 1 year of Risk Adjustment Audit experience
Distraction-free environment with high speed internet and ability to hardwire into a modem/router with an ethernet cable.
Expertise in medical documentation, fraud, abuse and penalties for documentation and coding violations based on governmental guidelines
Expertise in assigning accurate ICD-10-CM and HCC medical codes
Proven ability to support coding judgment and decisions using industry standard evidence and tools
Must possess high level of dependability and is able to meet coding accuracy and production standards
Preferred:
CRC and CPMA
RADV or IVA auditing experience
This is a remote, work from home position. You may be located anywhere within the US.
#CSIRISKADJ
