Coding Auditor Sr

Elevance Health-posted about 15 hours ago
Full-time • Mid Level
Remote • Nashville, TN
5,001-10,000 employees
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JR171732 Coding Auditor Sr CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through homecare and community-based services. The CareBridge Coding Auditor Sr is responsible for auditing coders that diagnosis data collected from physician and hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. Hours: 8:00a - 5:00p, Monday - Friday

  • Audits coders that diagnosis data retrieved from physician and hospital medical records and/or data extract files for both revenue project and RADV.
  • Assists with National and Targeted Risk Adjustment Data Validation audits.
  • Participates and represents the department in business leadership groups.
  • Serves as a subject matter exert.
  • Assesses and identifies training opportunities.
  • Maintains current knowledge of requirements and guidance required in the performance of audit duties.
  • Requires a H.S. diploma or equivalent and minimum of 3 years of experience as coder of medical records in physician office, hospital, or insurance/coding office setting; or any combination of education and experience, which would provide an equivalent background.
  • CPC or CRC Certification is needed for this position.
  • Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute).
  • Experience working with Medicare Advantage and Medicaid preferred.
  • Experience with ICD-10 coding, CPT and CPTII a plus.
  • HCC coding preferred.
  • Familiarity with electronic indexes is highly preferred.
  • Experience with telehealth visits is preferred.
  • We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
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