Retro-Coding - Coder Quality Specialist

Centauri Health Solutions provides technology and technology-enabled services to payors and providers across all healthcare programs, including Medicare, Medicaid, Commercial and Exchange. In partnership with our clients, we improve the lives and health outcomes of the members and patients we touch through compassionate outreach, sophisticated analytics, clinical data exchange capabilities, and data-driven solutions. Our solutions directly address complex problems such as uncompensated care within health systems; appropriate, risk-adjusted revenue for specialized sub-populations; and improve access to and quality of care measurement. Headquartered in Scottsdale, Ariz., Centauri Health Solutions employs 1700 dedicated associates across the country. Centauri has made the prestigious Inc. 5000 list since 2019, as well as the 2020 Deloitte Technology Fast 500™ list of the fastest-growing companies in the U.S. For more information, visit www.centaurihs.com.
Role Overview
The Coder Quality Specialist conducts coding quality audits on internal and external coders to ensure diagnoses are appropriately and accurately assigned based upon written clinical documentation, Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The Coder Quality Specialist applies guidance provided for the audit of the following programs; including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA (Initial Validation Audit), Medicaid, and Medicare RADV (Risk Adjustment Data Validation).
Role Responsibilities

• Perform audits of coded medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation
• Provide formal report(s) on audit findings and conduct education to internal and external coders based upon those findings
• Assist coding leadership by making recommendations for process improvements to further enhance coding quality goals and outcomes
• Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations
• Consistently maintain a minimum 95% accuracy rate on audits by coding leadership
• Meet minimum productivity requirements as outlined by the project terms
• Performs other related duties as required or assigned

Role Requirements:

• Minimum of 3 years of hands on coding experience in the Risk Adjustment environment.
• Minimum of 2 years' experience conducting coder audits in the Risk Adjustment environment.
• Strong Excel skills (advanced level)
• Technically savvy with Microsoft Office applications
• Strong written and verbal communication skills
• Ability to work independently in a remote environment
• High School Diploma
• Completion of an accredited medical coding program is highly desired, but not required
• Current core coding credential through AHIMA or AAPC (RHIT, CCS, CCS-P, CPC, CIC, etc.) and the AAPC CRC (Certified Risk Adjustment Coder) coding certification are both required.

We believe strongly in providing employees a rewarding work environment in which to grow, excel and achieve personal as well as professional goals. We offer our employees competitive compensation and a comprehensive benefits package that includes generous paid time off, a matching 401(k) program, tuition reimbursement, annual salary reviews, a comprehensive health plan, the opportunity to participate in volunteer activities on company time, and development opportunities. This position is bonus eligible in accordance with the terms of the Company's plan.
Centauri currently maintains a policy that requires several in-person and hybrid office workers to be fully vaccinated. New employees in the mentioned categories may require proof of vaccination by their start date. The Company is an equal opportunity employer and will provide reasonable accommodation to those unable to be vaccinated where it is not an undue hardship to the company to do so as provided under federal, state, and local law.
Factors which may affect starting pay within this range may include geography/market, skills, education, experience and other qualifications of the successful candidate.
This position is bonus eligible in accordance with the terms of the Company's plan.
Other details

• Pay Type Hourly
• Min Hiring Rate $23.70
• Max Hiring Rate $34.15

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