Quality Review and Audit Analyst, Individual & Family Plans

Remote Full-time
Job Description:
• conduct medical records reviews with accurate diagnosis code abstraction
• utilize HHS’ Risk Adjustment Model
• apply longitudinal thinking for data capture
• perform various documentation and data audits
• collaborate with team members and matrix partners
• coordinate with stakeholders to execute RA programs
• communicate effectively across all audiences
• develop and implement internal program processes

Requirements:
• high school diploma
• at least 2 years’ experience in coding certifications
• experience with medical documentation audits
• proficiency with ICD-10-CM coding guidelines
• familiarity with CMS regulations for Risk Adjustment programs
• HCC coding experience preferred
• computer competency with excel, MS Word, Adobe Acrobat
• detail oriented
• self-motivated
• excellent organization skills
• understanding of medical claims submissions preferred

Benefits:
• medical
• vision
• dental
• well-being and behavioral health programs
• 401(k)
• company paid life insurance
• tuition reimbursement
• a minimum of 18 days of paid time off per year
• paid holidays

Apply Now

Apply Now
Apply Now

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