Coding Quality Auditor

About Our Client:The organization operates within the healthcare industry, delivering coordinated and compassionate care across multiple states through a large network of medical groups and affiliate practices. It addresses the challenge of providing accessible, quality healthcare services to diverse communities while supporting a broad provider network and numerous clinics. About the Opportunity:The CODING QUALITY AUDITOR role is focused on ensuring the accuracy and compliance of clinical documentation and coding related to Risk Adjustment and Hierarchical Condition Category (HCC) coding. This position plays a critical part in validating diagnostic information and supporting compliant reporting and billing processes, thereby contributing to the integrity and effectiveness of the organization's revenue capture and quality assurance efforts. Responsibilities:Conduct detailed diagnostic chart reviews of clinical documentation and coding.Review and abstract HCC codes for accuracy and specificity.Query providers to clarify or validate diagnostic criteria.Ensure compliant documentation for accurate reporting, billing, and RVU capture.Collaborate with the Quality Integrity Program manager and clinical documentation review team.Maintain compliance with Official Coding Guidelines, coding conventions, and regulatory requirements. Requirements:Minimum of 2 years' experience in medical insurance reimbursement, medical billing, and coding related to charge review and work RVUs.Experience reviewing patient account information, insurance benefits explanations, computer records, and financial data.Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) within 1 year of hire.Preferred qualifications include a Bachelor's degree or equivalent, and certifications such as Certified Risk Adjustment Coder (CRC), Certified Professional Medical Auditor (CPMA), or Certified Healthcare Compliance Auditor (CHCA) within 1 year of hire.Experience in HCC coding is preferred. Pay Range and Compensation Package:The pay range for this position is posted as a minimum and maximum wage; placement within this range depends on relevant experience and other factors.Additional compensation may be available, including shift differentials, standby/on-call pay, overtime, premiums, extra shift incentives, or bonuses. Benefits & Perks:Retirement 401(k) Savings Plan with employer matching.Health care benefits including medical, dental, and vision insurance.Life insurance and disability insurance.Paid parental leave, vacations, holidays, and health-related time off.Voluntary benefits and well-being resources. Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:RemoteHunter is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.