Pride Health
QHP Auditor
This is a 13 weeks contract assignment.
Shift/Schedule:
Remote, M-F Job Summary: • 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.
This is a 13 weeks contract assignment.
Shift/Schedule:
Remote, M-F Job Summary: • 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.