Risk Adjustment Auditing Specialist

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Risk Adjustment Auditing Specialist 

At Norwood we’re forging our own path. We’re a remote-first staffing and consulting company specializing in mid-Revenue Cycle management within the healthcare industry. Our team of experts have placed thousands of professionals that support organizations ranging from small, community-based hospitals to the largest healthcare systems in the nation. Our mission? Bringing health to hospitals’ bottom lines. 

We are looking for remote-based Risk Adjustment Auditing Specialist. This role requires extensive and detailed knowledge of ICD-10 Official Guidelines and methodologies involved with Medicare Risk Adjustment (MRA). The Auditor will review validation of HCCs based on project specifications; provide feedback to ensure best coding practices; and maintain quality and production standards. The ideal individual will have experience with multiple risk models including CMS-HCC, knowledge of AHA Coding Clinic, and be able to provide education-focused feedback as necessary. This position is 100% remote and W2 status.  

Responsibilities: 

• Audit ICD-10-CM risk adjustment codes as applicable. 

• Provide audit-based feedback to ensure quality standards are maintained.  

• Provide education to coders/auditors for quality enhancement where applicable. 

• Meet or exceed quality and production standards as follows: Quality must meet or exceed 95% on average. Production must meet or exceed   

• Full Time Schedule required (40 hours/week).  

Requirements: 

• Minimum of 5 years of risk adjustment auditing in a production environment. 

• Experience in coding/auditing Quality Assurance & Education including delivery of feedback for skill advancement and documentation improvement preferred. 

• CPC and CRC required; additional certifications preferred.   

• Experience with CMS-HCC models required; additional models (ACA, MCD, etc.) preferred.   

• Ability to implement new or updated guidance directives when applicable.  

• Experience with Excel, EMRs, and Encoders. 

• Computer skills proficiency – MS Windows, MS Office (including Excel), Teams, Internet, etc. 

• High Speed Internet access. 

• Applicants must be authorized to work in the US. We are unable to sponsor or take over sponsorship for any employment visas at this time.

Skills Needed: 

• Extensive knowledge of ICD-10-CM Official Coding Guidelines, AHA Coding Clinic, and risk adjustment methodologies required.  

• Reliability and determination to meet standards as expected.  

• Discipline and dedication to succeed while working remotely with minimal oversight.  

Location: Remote,
Type: Contract
Pay: Apply for details

1740

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