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Risk Adjustment Auditor Educator
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- Position Purpose: Conduct provider medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of care.
- Subject matter experts for proper risk adjustment coding and CMS data validation Work in conjunction with other departments to include Provider Relations, Quality as well as the Medical Director for the state assigned to ensure compliance of CMS risk adjustments guidelines are met.
- Conduct provider education and training regarding risk adjustment to help to ensure accurate CMS payment and to improve quality of care.
- Works on additional risk adjustment audit requests (i.e. outside auditors' requests).
- 1 years of experience in medical records coding (HCC Coding) with knowledge of Medicare, Marketplace, and Medicaid risk adjustment is required.
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