Risk Adjustment Auditor: Precision Coding & Compliance

CommunityCare HMO Inc. seeks a Risk Adjustment Auditor to review medical records and ensure accurate diagnoses are captured according to CMS risk adjustment guidelines and ICD-10-CM coding standards. The role supports accurate risk score calculation, regulatory compliance, and program integrity within the organization. Responsibilities include bi-directional reviews, identifying coding gaps, reporting findings, and training staff while upholding HIPAA requirements and meeting productivity