Coding Quality Auditor - Remote
Posted 7 days ago by 1752835130
Negotiable
Outside
Remote
USA
Summary: The Coding Quality Auditor is responsible for validating and reviewing Hierarchical Condition Category (HCC) risk adjustable charts through retrospective chart reviews, ensuring accurate and compliant ICD-10 coding for risk adjustment submissions to CMS. The role requires applying clinical documentation standards and industry guidelines to support coding decisions while contributing to audit accuracy and process improvements. Candidates must have relevant coding/audit experience and familiarity with HIPAA regulations. This position is remote and classified as outside IR35.
Key Responsibilities:
- Validate and review HCC risk adjustable charts through retrospective chart reviews.
- Ensure accurate, complete, and compliant ICD-10 coding for risk adjustment submissions to CMS.
- Apply clinical documentation standards and industry guidelines to support coding decisions.
- Contribute to audit accuracy and process improvements.
- Maintain compliance with state/federal regulations and internal policies.
Key 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.
- Experience with Microsoft Office tools and industry-standard coding platforms.
- Completion of an AAPC or AHIMA coding program (e.g., CPC, CCS-P, CRC).
- Minimum of 3 years of relevant coding/audit experience.
Salary (Rate): undetermined
City: undetermined
Country: USA
Working Arrangements: remote
IR35 Status: outside IR35
Seniority Level: undetermined
Industry: Other
Title: Coding Quality Auditor - Remote
Mandatory skills:
coding, audit,
CMS, CMS coding guidelines,
Microsoft Office,
HIPAA, HIPAA compliant data handling, HIPAA privacy and security rules,
ICD-10 coding, Hierarchical Condition Category, HCC,
clinical documentation, risk adjustment audits, validation, coding decision,
charts, chart review, audit accuracy, process improvements,
AAPC, AHIMA, CPC, CCS-P, CRC
Description:
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.
Top 3 Skills:
1. Proficiency in ICD-10-CM coding with strong understanding of HCC risk adjustment
2. Attention to detail and accuracy in retrospective chart reviews
3. Familiarity with CMS coding guidelines and HIPAA-compliant data handling
3 years of relevant coding/audit experience.
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.
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.
VIVA USA is an equal opportunity employer and is committed to maintaining a professional working environment that is free from discrimination and unlawful harassment. The Management, contractors, and staff of VIVA USA shall respect others without regard to race, sex, religion, age, color, creed, national or ethnic origin, physical, mental or sensory disability, marital status, sexual orientation, or status as a Vietnam-era, recently separated veteran, Active war time or campaign badge veteran, Armed forces service medal veteran, or disabled veteran. Please contact us at for any complaints, comments and suggestions.
Contact Details :
VIVA USA INC.
3601 Algonquin Road, Suite 425
Rolling Meadows, IL 60008