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QHP Auditor (AHA)

Remote:

Full Remote

Contract:

Freelance

Salary:

19 - 19K yearly

Experience:

Senior (5-10 years)

Work from:

Massachusetts (USA), United States

Offer summary

Qualifications:

Current core coding credentials through AHIMA or AAPC, Minimum of 7 years coding experience, 5 in Risk Adjustment coding, Completion of accredited medical coding program, Technical skills in Microsoft Office, AAPC CRC certification recommended.

Key responsabilities:

Perform code abstraction and coding audits for ICD-10-CM codes
Ensure accurate assignment supported by clinical documentation
Maintain knowledge of related regulations and coding guidelines
Achieve a minimum 95% accuracy rate on projects
Assist with quality audits as needed

Resource Logistics Inc. SME https://www.resource-logistics.com/

201 - 500 Employees

See more Resource Logistics Inc. offers

Job description

Responsibilities
• Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM
codes are accurately assigned and supported by clinical documentation. Primarily for QHP
(RADV)
• Ability to code government and state models. This includes code everything projects.
• Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state
and federal regulations.
• Ability to maintain a 95% accuracy rate on all coding projects.
• Coders assist with code abstraction and coding quality audits using the Official Coding
Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all
state regulations, federal regulations, internal policies, and procedures.
Requirements
• Current core coding credentials through AHIMA or AAPC (RHIT, CCS, CCS-P, CPC, CIC, etc.)
The AAPC CRC (Certified Risk Adjustment Coder) coding certification is highly recommended.
• RADV Experience Mandatory
• Strong organizational skills
• Technical savvy with high level of competence in basic computer skills, Microsoft Outlook,
Word, Excel, and Outlook.
• Strong written and verbal communication skills
• Ability to work independently in a remote environment.
• Private lockable office space to ensure security of Member PHI
• Minimum of 7 years coding experience with at least 5 of those years in Risk Adjustment
coding.
• Completion of an accredited medical coding program with current unencumbered credentials.
Required education:
• CPC Certification
Required experience:
• Risk Adjustment coding: 5 years.
• Coding: 7 years
Supervision Received
• General supervision is received weekly