Risk Management Auditor

2 months ago

Villa Park, United States LHH Recruitment Solutions Full time
Job DescriptionJob Description

LHH is hiring a Risk Management Auditor for a remote short-term project. Join us in ensuring accurate risk adjustment reporting and compliance with healthcare standards. If you have experience in clinical coding and auditing, and are looking for an exciting project, this is a great opportunity

Key Responsibilities:

  • Conduct Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting.

  • Verify the accuracy and completeness of provider-reported diagnosis codes based on medical record documentation.

  • Review diagnosis codes in CMS HCC categories and ensure correct and complete coding.

  • Identify trends in provider coding and collaborate with Provider Education Consultants to develop improvement strategies.

  • Maintain knowledge of regulatory mandates, ensuring compliance with Risk Adjustment Program requirements.

  • Participate in quality improvement initiatives and assist in implementing regulatory changes.

Qualifications:

  • Associate degree in Healthcare or related field, with at least 3 years of experience in clinical coding or auditing, or an equivalent combination of education and experience.

  • Coding Certification (CRC and CPC) is required.

  • Risk Adjustment or HCC coding experience preferred.

  • Strong knowledge of ICD-9-CM/ICD-10 Coding Guidelines.

  • Demonstrated ability to perform accurate and complete chart reviews.

  • Excellent verbal and written communication skills.

This is a remote position, offering the flexibility to work from home. The project is expected to last for a limited duration, and the hourly pay rate is $24 - $29 per hour.

If you're looking to apply your expertise in clinical coding and risk adjustment, apply now to join us at LHH



Pay Details: $24.00 to $29.00 per hour

Search managed by: Allyson Leahy

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
  • The California Fair Chance Act
  • Los Angeles City Fair Chance Ordinance
  • Los Angeles County Fair Chance Ordinance for Employers
  • San Francisco Fair Chance Ordinance

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