Quality Review and Audit Analyst, Individual & Family Plans
- 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