Risk Adjustment Auditor Educator (Healthcare)

Location: Remote-GA, United States

Salary: $56,200–$101,000 per year

Company

hirify.global is a diversified national healthcare organization serving 28 million members.

What you will do

• Conduct provider medical record audits and analyze practice coding patterns and MRA data.
• Serve as a subject matter expert on risk adjustment coding and CMS data validation.
• Develop provider- and market-level interventions and coordinate educational work plans for contracted providers.
• Deliver risk adjustment education and training through provider offices, hospitals, webinars, conference calls, and email.
• Perform additional risk adjustment audits, including requests from outside auditors, and participate as a subject matter expert on the RADV Committee.
• Perform quality assurance audits of medical coding specialists and communicate results, improvement suggestions, and retraining topics.

Requirements

• Bachelor’s degree or equivalent experience.
• 5+ years of experience as a medical coder in a hospital, physician setting, or managed care organization.
• 2+ years of coding experience with Medicare risk adjustment and HCC coding knowledge.
• Experience teaching, training, or working as an educator/instructor.
• CPC or CCS certification required at hire.
• CRC certification required within the first year of employment.

Nice to have

• Provider education experience.
• Managed care experience.
• CPMA certification preferred in the second year of employment.

Culture & Benefits

• Full-time employment with a flexible remote, hybrid, field, or office work approach.
• Health insurance, 401(k), and stock purchase plans.
• Tuition reimbursement, paid time off, and holidays.
• Competitive pay adjusted for skills, experience, education, and other job-related factors.