Coding Auditor Senior
Core
Audits diagnosis data from physician and hospital medical records to ensure proper ICD-9/ICD-10 coding and compliance with risk adjustment requirements.
Role type
Senior medical coding auditor
Builds
Revenue project and RADV audit reports; National and Targeted Risk Adjustment Data Validation audit results
Domain
Healthcare administration / Medical coding
Deliverable
dashboards & analysis
Required skills
Medical record coding, ICD-9/ICD-10 coding, Risk adjustment data validation, Data extraction, Regulatory compliance knowledge, Training development
Preferred skills
Medicare Advantage experience, HCC coding, ICD-9 coding
Technologies
Medical record systems, Data extract files
Responsibilities
Audit diagnosis data from medical records and data extracts for revenue and risk adjustment projects; Assist with National and Targeted Risk Adjustment Data Validation audits; Participate in business leadership groups; Serve as subject matter expert and identify training opportunities; Maintain current knowledge of audit requirements and guidance.
