Managing Consultant - Risk Adjustment Coding Compliance

Responsibilities

• Design audit plans for coding and documentation compliance assessments
• Conduct coding and documentation audits to ensure compliance with CPT-4/HCPCS and ICD-10-CM guidelines
• Analyze audit findings to identify trends and recommend improvements
• Assist with development and editing of billing and coding compliance policies and procedures
• Communicate audit results and manage client relationships effectively
• Generate documentation and contribute to expert reports on audit findings
• Monitor relevant compliance resources and stay current on coding guidelines

Qualifications

• Bachelor's Degree in Health Information Management or related field
• 5+ years of risk adjustment coding experience as an auditor/coder
• 3+ years of CPT-4/HCPCS and ICD-10-CM coding experience in a medical setting
• Active coding certification (CPC or CCS-P) and risk adjustment certification (CRC)
• Prior experience as certified medical auditors or compliance professionals, and/or licensed clinicians
• Comprehensive knowledge of Medicare coding and documentation regulations
• Advanced knowledge of coding systems and ability to conduct research on coding queries

Benefits

• Hybrid work model with a preference for Tampa, FL office presence
• Opportunity to manage and mentor junior staff
• Engagement in educational meetings and compliance program initiatives
• Involvement in business development and office functions such as recruiting
• Access to ongoing training and professional development opportunities

Pay

$100,000 – $230,000 annually

Schedule

Remote - US based candidates only, no visa sponsorship available