Coding Auditor Senior

Title: Coding Auditor Sr

locations

TN-NASHVILLE, 926 MAIN ST

GA-ATLANTA, 3030 HEADLAND DR SW

IN-INDIANAPOLIS, 220 VIRGINIA AVE

FL-TAMPA, 5411 SKY CENTER DR

VA-NORFOLK, 5800 NORTHAMPTON BLVD

time type

Full time

job requisition id

JR171732

Position Title:

Coding Auditor Sr

Job Description:

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

How will you make an impact:

• 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.

Minimum requirements:

• 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.

Preferred Skills, Capabilities, and Experiences:

• 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.

• CPC or CRC Certification is needed for this position.

• Familiarity with electronic indexes is highly preferred.

• Experience with telehealth visits is preferred.

Job Level:

Non-Management Non-Exempt

Workshift:

Job Family:

MED > Licensed/Certified - Other

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.