Coding Auditor
Posted 1 week ago by 1750480713
Negotiable
Outside
Remote
USA
Summary: The Coding Auditor role involves validating and reviewing Hierarchical Condition Category (HCC) risk adjustable charts through retrospective chart reviews. The position requires ensuring accurate ICD-10 coding for risk adjustment submissions to CMS while adhering to clinical documentation standards and industry guidelines. Candidates must possess relevant coding certifications and have experience in retrospective risk adjustment audits. This is a fully remote position with a focus on compliance and process improvements in coding practices.
Key Responsibilities:
- Validate and review Hierarchical Condition Category (HCC) risk adjustable charts through retrospective chart reviews.
- Ensure accurate, complete, and compliant ICD-10 coding for risk adjustment submission to CMS.
- Apply clinical documentation standards and industry guidelines to support coding decisions.
- Contribute to audit accuracy, process improvements, and maintain compliance with state/federal regulations and internal policies.
Key Skills:
- CPC, CCS-P, CRC Certifications required (any 1 Required).
- Proficiency in ICD-10-CM coding with strong understanding of HCC risk adjustment.
- Attention to detail and accuracy in retrospective chart reviews.
- Familiarity with CMS coding guidelines and HIPAA-compliant data handling.
- Experience working with Microsoft Office tools and industry-standard coding platforms.
- Prior experience in retrospective risk adjustment audits and validation preferred.
Salary (Rate): undetermined
City: undetermined
Country: USA
Working Arrangements: remote
IR35 Status: outside IR35
Seniority Level: undetermined
Industry: IT
Job Title: Coding Auditor
Duration: 4+ Months
Fully Remote
Job Description:
- 3 years of relevant coding/audit experience.
- The Coding Quality Auditor will be responsible for validating and reviewing Hierarchical Condition Category (HCC) risk adjustable charts through retrospective chart reviews.
- The role focuses on ensuring accurate, complete, and compliant ICD-10 coding for risk adjustment submission to CMS.
- Candidates must apply clinical documentation standards and industry guidelines to support coding decisions. This role contributes to audit accuracy, process improvements, and helps maintain compliance with state/federal regulations and internal policies.
Required:
CPC, CCS-P, CRC Certifications required (any 1 Required)
Top 3 Skills:
- Proficiency in ICD-10-CM coding with strong understanding of HCC risk adjustment
- Attention to detail and accuracy in retrospective chart reviews
- Familiarity with CMS coding guidelines and HIPAA-compliant data handling
Candidates must have experience working with Microsoft Office tools and industry-standard coding platforms. Prior experience in retrospective risk adjustment audits and validation is preferred. All audits must be performed in compliance with HIPAA privacy and security rules.
Education:
AA/AS degree or equivalent experience.
Completion of an AAPC or AHIMA coding program (e.g., CPC, CCS-P, CRC) with a minimum of 3 years of relevant coding/audit experience.
About IDEXCEL, INC
IDEXCEL is an IT services organization, with a mission to bring great people and great organizations together. Our diverse client base represents a wide range of industries, including technology, telecom, insurance, healthcare, manufacturing, banking & financial services, food & commodities trading and federal organizations. Our teams of experienced recruiters directly work with client companies seeking exceptional people to help with their business initiatives.
IDEXCEL, Inc. is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law.