Medasource
Title:
Health Plan Coding Auditor – RADV (Remote, EST Hours) Type:
Contract Openings:
3 Schedule:
Monday–Friday,
7:00 AM–3:30 PM EST (non-negotiable) Location:
100% Remote (must work EST hours) Overview We are seeking experienced
Health Plan Coding Auditors
to support large-scale
RADV and Quality Health Plan (QHP)
audit initiatives. This role focuses on
ICD-10-CM code abstraction, coding validation, and risk adjustment accuracy
within a payer environment. This position requires strict adherence to scheduled work hours and
exclusive commitment
during the assignment (no secondary employment permitted). Key Responsibilities Perform
RADV/QHP code abstraction and coding quality audits
using ICD-10-CM. Review medical records to ensure diagnoses are
accurately captured and fully supported
by documentation. Code
government and state risk adjustment models , including full “code-everything” projects. Apply Official Coding Guidelines, AHA Coding Clinic guidance, CMS requirements, and state/federal regulations. Maintain
95% coding accuracy
across all assigned audits. Document findings clearly and follow internal audit workflows and policies. Required Qualifications 7+ years of coding experience , with
5+ years in Risk Adjustment (RADV required) . Active AHIMA or AAPC certification (CPC required; CRC strongly preferred). Experience auditing within a
health plan / payer environment . Strong ICD-10-CM knowledge for risk adjustment models. Proficiency with Microsoft Excel, Outlook, and Word. Ability to work independently in a secure, remote environment. Private, lockable home office to protect PHI. Must attest to
no other employment during assignment . EST hours required (7:00 AM start)
— engagement during core hours is mandatory.
Health Plan Coding Auditor – RADV (Remote, EST Hours) Type:
Contract Openings:
3 Schedule:
Monday–Friday,
7:00 AM–3:30 PM EST (non-negotiable) Location:
100% Remote (must work EST hours) Overview We are seeking experienced
Health Plan Coding Auditors
to support large-scale
RADV and Quality Health Plan (QHP)
audit initiatives. This role focuses on
ICD-10-CM code abstraction, coding validation, and risk adjustment accuracy
within a payer environment. This position requires strict adherence to scheduled work hours and
exclusive commitment
during the assignment (no secondary employment permitted). Key Responsibilities Perform
RADV/QHP code abstraction and coding quality audits
using ICD-10-CM. Review medical records to ensure diagnoses are
accurately captured and fully supported
by documentation. Code
government and state risk adjustment models , including full “code-everything” projects. Apply Official Coding Guidelines, AHA Coding Clinic guidance, CMS requirements, and state/federal regulations. Maintain
95% coding accuracy
across all assigned audits. Document findings clearly and follow internal audit workflows and policies. Required Qualifications 7+ years of coding experience , with
5+ years in Risk Adjustment (RADV required) . Active AHIMA or AAPC certification (CPC required; CRC strongly preferred). Experience auditing within a
health plan / payer environment . Strong ICD-10-CM knowledge for risk adjustment models. Proficiency with Microsoft Excel, Outlook, and Word. Ability to work independently in a secure, remote environment. Private, lockable home office to protect PHI. Must attest to
no other employment during assignment . EST hours required (7:00 AM start)
— engagement during core hours is mandatory.