Certified Coding Specialist AnalystVirtualVocations • Asheville, North Carolina, United States
Certified Coding Specialist Analyst
VirtualVocations • Asheville, North Carolina, United States
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A company is looking for an Individual & Family Plans (IFP) Quality Review and Audit Analyst.
Key Responsibilities
Conduct medical records reviews and abstract diagnosis codes in compliance with relevant guidelines
Utilize HHS' Risk Adjustment Model to ensure accuracy of Hierarchical Condition Categories (HCC)
Perform audits to identify gaps in risk adjustment data and compliance risks for IFP programs
Required Qualifications
High school diploma
At least 2 years of experience in medical coding or related fields
Certification from AHIMA or AAPC (e.g., CPC, CCS-P, RHIT)
Ability to obtain Certified Risk Adjustment Coder (CRC) certification within 6 months of hire
Experience with compliance and quality audits in healthcare settings
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