Associate Risk Adjustment Auditor
Cambia Health Solutions

Job Info

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Associate Risk Adjustment Auditor

Work Remotely from Oregon, Washington, Idaho or Utah

Primary Job Purpose

The Associate Risk Adjustment Auditor performs Retrospective/Prospective chart review both on and off-site utilizing various types of records to ensure accurate risk adjustment reporting. Identifies trends in provider coding/documentation and works closely with Provider Education Consultants to develop intervention strategies.

General Functions and Outcomes

• Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting.
  
• Verifies and ensures the accuracy, completeness, specificity and appropriateness of provider-reported diagnosis codes based on medical record documentation.
  
• Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories.
  
• Identifies trends in provider coding and documentation and partners with Provider Education Consultants to develop intervention strategies.
  
• Supports and actively participates in process and quality improvement initiatives.
  
• Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with requirements.
  
• Consistently meets departmental performance and attendance requirements.
  

Minimum Requirements

• Demonstrated ability to perform accurate and complete chart reviews for risk adjustment.
  
• Knowledge of and adherence to Official ICD-9-CM/ICD-10 Coding Guidelines.
  
• Demonstrates analytical ability to identify problems, develop solutions, and implement actions in a timely manner.
  
• Demonstrated ability to identify and communicate trends in provider coding and documentation.
  
• Demonstrated proficient PC skills and familiarity with corporate software, such as Word, Excel and Outlook.
  
• Effective verbal and written communication skills.
  

Normally to be proficient in the competencies listed above

Risk Adjustment Auditor I would have an Associate degree in Healthcare or related field and one year of experience in clinical coding or auditing or equivalent combination of education and experience. Coding Certification (CCA, CCS, CCS-P, CPC, or CPC-P) required. Risk Adjustment, HCC or Inpatient coding experience preferred.

Work Environment

• Travel may be required, locally or out of state.
• May be required to work overtime.
• May be required to work outside normal hours.

Associate Risk Adjustment

The base pay annual salary range for this job is $52,000 to $84,500.

At Cambia, we take a variety of factors into account when creating a job offer, including your skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. While we offer competitive salaries, in general, we rarely hire candidates at or near the top of the salary range.

Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:

• medical, dental, and vision coverage for employees and their eligible family members
  
• annual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)
  
• paid time off and company holidays
  
• up to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)
  
• up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)
  
• one-time furniture and equipment allowance for employees working from home
  
• up to $225 in Amazon gift cards for participating in various well-being activities for a complete list see our External Total Rewards page.
  

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.

This job has expired.