Motus Recruiting and Staffing, Inc. · 3 weeks ago
Risk Adjustment Auditor II – Healthcare Industry!
United States
Contract
Remote
Senior Level
$34.36/hr - $34.36/hr
5+ years expMotus Recruiting and Staffing, Inc. is a leading healthcare organization dedicated to improving member and provider experiences. They are seeking a Risk Adjustment Auditor II to support accurate risk adjustment reporting through chart reviews and to validate diagnosis code accuracy while collaborating with provider education and clinical partners.
Human ResourcesInformation Technology
Hiring Manager
Kariann Lyons
Responsibilities
Perform retrospective and prospective chart reviews, both onsite (as applicable) and remotely, to ensure accurate risk adjustment reporting
Verify the accuracy, completeness, specificity, and appropriateness of provider-reported diagnosis codes based on medical record documentation
Review medical records to ensure complete diagnosis code capture aligned with CMS HCC categories
Identify trends in provider coding and documentation and collaborate with Provider Education Consultants to develop targeted intervention strategies
Support and actively participate in process improvement and quality initiatives
Maintain current knowledge of regulatory mandates and ensure compliance with all applicable requirements
Meet departmental productivity, quality, and attendance standards consistently
Serve as a mentor and subject matter resource to Risk Adjustment Auditor I staff
Assist with special projects, including risk mitigation reviews
Monitor and interpret regulatory changes impacting risk adjustment programs and support implementation efforts as needed
Qualification
Required
CRC – Certified Risk Adjustment Coder
CPC – Certified Professional Coder
5–7 years of experience in clinical coding, auditing, or an equivalent combination of education and experience
Demonstrated ability to perform accurate and complete chart reviews for risk adjustment
Advanced knowledge of risk adjustment, diagnosis coding, and documentation requirements
Strong working knowledge of ICD-9-CM and ICD-10 Coding Guidelines
Experience identifying and communicating trends in provider coding and documentation
Strong analytical and problem-solving skills with the ability to implement solutions efficiently
Proficiency with Microsoft Office (Word, Excel, Outlook) and general PC skills
Strong written and verbal communication skills
Knowledge of health system operations, reimbursement methodologies, and coding conventions for governmental and commercial products
Ability to provide proactive and creative solutions to complex business problems
Preferred
Associate degree in Healthcare or a related field preferred
Company
Motus Recruiting and Staffing, Inc.
Founded in 2006, Motus Recruiting is an award-winning firm in the Pacific Northwest specializing in accounting and finance, professional services, technology solutions, and executive search.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Orlando Williams
Chief Executive Officer
Recent News
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