Remote Coding Quality Specialist

Centauri Health Solutions

23h•Remote

About The Position

Centauri delivers data-driven technology solutions that transform fragmented clinical and member data into actionable intelligence — maximizing accuracy, quality performance, and outcomes for health plans and health systems. Through close collaboration with our customers, Centauri improves patient and member outcomes by providing advocacy, advanced data insights, and intelligent clinical data delivery. The company addresses critical healthcare challenges for complex populations and improves access and quality of care. Headquartered in Tempe, Arizona, Centauri Health Solutions employs 1100 dedicated associates across the country and has been recognized on the Inc. 5000 list, the 2020 Deloitte Technology Fast 500™, and has been recognized as 2026 Best in KLAS for ADT Notifications. Role Summary: Are you a complete code capture specialist? Have you been certified for 5 years? If so, we need to talk! The Coding Quality Specialist conducts coding quality reviews on internal and external coders to ensure diagnoses are appropriately and accurately assigned based upon clinical documentation, ICD-10-CM Official Guidelines for Coding and Reporting, AHA Coding Clinic Guidance, CMS program guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The Coding Quality Specialist will apply guidance provided for the medical record code abstraction primarily for Medicaid lines of business (Complete Code Capture), but may also include Medicare Advantage Risk Adjustment or Commercial Risk Adjustment. Must have Minimum of 1 year coding experience with Complete Code Capture. Minimum of 5 years certified with a core coding credential from AHIMA or AAPAHIMA – CCS, CCS-P, AAPC – CPC, CRC.

Requirements

Minimum of 3 recent years of production coding experience in Retrospective Risk Adjustment coding (must be within last 6 months)
Minimum of 2 years experience conducting coder audits in the Risk Adjustment environment
Required code set knowledge and coding experience in Medicaid (primary), Medicare, Commercial Minimum of 1 year coding experience with Complete Code Capture
Minimum of 5 years certified with a core coding credential from AHIMA or AAPAHIMA – CCS, CCS-P, AAPC – CPC, CRC (no apprentice credentials accepted)
Strong organizational skills
Technical savvy with high level of competence in basic computers, Microsoft Outlook, Word, and Excel
Strong written and verbal communication skills
Ability to work independently in a remote environment

Responsibilities

Perform coding quality reviews of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation
Provide formal reports on audit findings and conduct education to internal and external coders based upon those findings
Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations
Ability to pass coding quiz with 80% accuracy
Consistently maintain a minimum 95% accuracy on audits by coding leadership
Meet minimum productivity requirements as outlined by the project terms
Ability to adhere to client guidelines when superseding other guidelines
Assist coding leadership by making recommendations for process improvements to further enhance coding goals and outcomes
Handle other related duties as required or assigned