Risk Adjustment - Risk Adjustment Coding Auditor 135-2014
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JOB SUMMARY: The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards.
This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity.
KEY
RESPONSIBILITIES
• Perform bi-directional retrospective and prospective medical record reviews to validate, clarify, and accura…
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