Risk Adjustment Auditor in Portland, Oregon - #66468 | VanderHouwen

Description

Job Id: 66468

Risk Adjustment Auditor
Our client is seeking a diligent and experienced Risk Adjustment Auditor to perform both retrospective and prospective chart reviews on and off-site using various types of records. The ideal candidate will ensure accurate risk adjustment reporting, identify trends in provider coding/documentation, and work closely with Provider Education Consultants to develop effective intervention strategies.

This role is fully remote for candidates who reside in OR, WA, UT, or ID. This role operates on an 8-hour shift during core hours from 6:00 am to 5:00 pm Pacific Time, with candidates required to work Pacific Time Zone hours, including potential overtime and weekends as needed.

Risk Adjustment Auditor Responsibilities

• Conduct retrospective and prospective chart reviews to validate accurate risk adjustment reporting.
• Verify and ensure the accuracy, completeness, specificity, and appropriateness of provider-reported diagnosis codes based on medical record documentation.
• Review medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories.
• Identify and communicate trends in provider coding and documentation, partnering with Provider Education Consultants to devise and implement intervention strategies.
• Support and actively participate in process and quality improvement initiatives.
• Maintain up-to-date knowledge of relevant regulatory mandates and ensure compliance with these requirements.
• Consistently meet departmental performance standards and attendance requirements.
• Serve as a mentor to Risk Adjustment Auditor I staff and assist with risk mitigation reviews.
• Act as a subject matter resource on the risk adjustment process and diagnosis coding.
• Monitor and interpret regulatory changes impacting the Risk Adjustment Program, assisting with implementation activities as needed.

Risk Adjustment Auditor Qualifications

• Associate degree in Healthcare or a related field, or an equivalent combination of education and experience.
• Three years of experience in clinical coding or auditing.
• Demonstrated ability to perform accurate and complete chart reviews for risk adjustment.
• Proficiency in using PC and corporate software applications (Word, Excel, Outlook).
• Effective verbal and written communication skills.
• Advanced knowledge of risk adjustment, coding, and documentation requirements.
• Knowledge of health systems operations, including understanding of reimbursement methodologies and coding conventions for governmental and commercial products.
• Required Certifications: Certified Risk Adjustment Coder (CRC) and Certified Professional Coder (CPC).

Compensation:$28-$30/hr. (DOE)

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Benefits
Benefits are available to eligible VanderHouwen contractors and include coverage for medical, dental, vision, life insurance, short and long term disability, and matching 401k.

About VanderHouwen
VanderHouwen is an award-winning, Women-Owned, WBENC certified professional staffing firm. Founded in 1987, VanderHouwen has been successfully placing experienced professionals throughout the Pacific Northwest and nationwide. Our recruitment teams are highly specialized in either Technology and IT, Engineering, or Accounting and Finance career markets. Our recruiters value building meaningful, professional relationships with each candidate as well as developing honed knowledge of companies' staffing needs and workplaces. Partner with us to land your next exciting career.

VanderHouwen is an Equal Opportunity Employer and participates in E-Verify. VanderHouwen does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, or any other characteristic protected by applicable local, state or federal civil rights laws.

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