CareSource · 1 month ago
Risk Adjustment Coding Auditor II (AAPC or AHIMA coding certification required)
United States
Full-time
Remote
Mid Level
3+ years expCareSource is a healthcare company dedicated to improving health outcomes for its members. The Risk Adjustment Coding Auditor II is responsible for performing over-reads of vendor ICD-10 coding and reviewing provider documentation to ensure accurate diagnostic coding and compliance with guidelines.
Health CareMedicalNon Profit
Responsibilities
Meets assigned volume metrics
Validates the accurateness of ICD-10 codes assigned by the vendor
Tracks the trends and reports on the findings
Demonstrates a thorough understanding of Risk Adjustment hierarchical condition categories (HCCs), for all risk adjusted products
Participates in quality coding initiatives as appropriate or assigned
Maintains knowledge of AHA Coding Clinic and ICD-10 Official Guidelines for Coding and Reporting
May be asked to perform over reads of provider coding/documentation
Meets deadlines and works independently on multiple projects
Perform any other job duties as requested
Qualification
Required
High School Diploma or GED is required
Minimum of three (3) years of diagnostic coding experience and a firm understanding of ICD-10 is required
A minimum of three (3) years of experience in auditing medical records is required
Risk Adjustment methodology experience required
AAPC or AHIMA coding certification is required
Intermediate level with Microsoft Word, Microsoft Outlook, Microsoft Excel
Ability to work in a fast paced production environment while maintaining high quality
Knowledgeable and experienced with researching CMS and other sites for Risk Adjustment guidance
Exceptional knowledge of medical coding and regulatory requirements
Knowledgeable of Medicaid, Medicare, Exchange
Knowledgeable of ICD-10
Ability to make independent decisions on ICD 10 code assignments
Excellent verbal and written communication skills
Ability to effectively interface with teammates, vendors and management
Ability to work with others and work independently
Possesses critical thinking/listening skills
Strong interpersonal skills and high level or professionalism
Detail oriented
Preferred
Facets training/knowledge is preferred
Benefits
Substantial and comprehensive total rewards package
Company
CareSource
CareSource provides managed care services to Medicaid beneficiaries.
1001-5000 employees
H1B Sponsorship
CareSource has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (30)
2024 (39)
2023 (35)
2022 (21)
2021 (37)
2020 (28)
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
FHLB Cincinnati
2026-01-17Grant
Leadership Team
Erhardt Preitauer
President & Chief Executive Officer
Jason Bearden
Market President and CEO, Georgia
Recent News
2026-01-18
Dayton Daily News
2025-12-17
Company data provided by crunchbase