Talent.com
QHP Auditor (AHA)
QHP Auditor (AHA)ICONMA • MA, US
QHP Auditor (AHA)

QHP Auditor (AHA)

ICONMA • MA, US
27 days ago
Job type
  • Full-time
Job description

Our Client, a Medical Center company, is looking for a QHP Auditor (AHA) for their Remote location.

Responsibilities :

  • Perform code abstraction and / or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation. Primarily for QHP (RADV)
  • Ability to code government and state models. This includes code everything projects.
  • Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations.
  • Ability to maintain a 95% accuracy rate on all coding projects.
  • Coders assist with code abstraction and coding quality audits using the Official Coding
  • Guidelines for ICD-9-CM / ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and procedures.

Requirements :

  • Current core coding credentials through AHIMA or AAPC (RHIT, CCS, CCS-P, CPC, CIC, etc.)
  • The AAPC CRC (Certified Risk Adjustment Coder) coding certification is highly recommended.
  • RADV Experience Mandatory
  • Strong organizational skills
  • Technical savvy with high level of competence in basic computer skills, Microsoft Outlook,
  • Word, Excel, and Outlook.
  • Strong written and verbal communication skills
  • Ability to work independently in a remote environment.
  • Private lockable office space to ensure security of Member PHI
  • Minimum of 7 years coding experience with at least 5 of those years in Risk Adjustment coding.
  • Completion of an accredited medical coding program with current unencumbered credentials.
  • CPC Certification
  • Risk Adjustment coding : 5 years.
  • Coding : 7 years
  • Why Should You Apply?

    Health Benefits

    Referral Program

  • Excellent growth and advancement opportunities
  • As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.

    Create a job alert for this search

    Auditor • MA, US

    Related jobs
    Compliance Specialist (STL)

    Compliance Specialist (STL)

    InsideHigherEd • Lowell, Massachusetts, United States
    Full-time
    Salary commensurate with experience within the grade / range and grant / See salary ranges below in posting text.The UMass Lowell (UML) Submillimeter Wave Technology Laboratory (STL) is seeking a Compl...Show more
    Last updated: 1 day ago • Promoted
    Remote FP&A Manager – AI Trainer ($50-$60 / hour)

    Remote FP&A Manager – AI Trainer ($50-$60 / hour)

    Data Annotation • Pawtucket, Rhode Island
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show more
    Last updated: 30+ days ago • Promoted
    Health Physical Therapist

    Health Physical Therapist

    Visiting Rehab and Nursing Services • Attleboro, MA, US
    Part-time
    PT (Physical Therapist) Attleboro, MA.Must have 1 year clinical experience •.Per Visit | Make Your Own Hours | Comprehensive Benefits. Officially a 2024 Top Place to Work by the Boston Globe and USA...Show more
    Last updated: 10 days ago • Promoted
    Auditor

    Auditor

    CFS • Lexington, MA, US
    Full-time
    Auditor - Retail Industry Focus (30-50% Travel).Presented by Creative Financial Staffing.Creative Financial Staffing (CFS) has partnered with a. This role offers the opportunity to work with a diver...Show more
    Last updated: 20 days ago • Promoted
    Recovery Specialist III (2nd shift)

    Recovery Specialist III (2nd shift)

    Spectrum Health Systems, Inc • Methuen, MA, United States
    Full-time
    Methuen, MA - Bright Futures (program for adolescent males).Maintaining primary responsibility for the safety and security of residents and staff on the assigned shift. Ensuring that behavior manage...Show more
    Last updated: 30+ days ago • Promoted
    LMHC Needed in Massachusetts

    LMHC Needed in Massachusetts

    CHG Healthcare • Lowell, MA, US
    Full-time
    The city of Lowell is the perfect example of scenic New England.Over the years Lowell has gained a reputation as a great holiday destination, thanks to its mix of interesting museums, relaxing park...Show more
    Last updated: 28 days ago • Promoted
    Channel Compliance Senior Analyst

    Channel Compliance Senior Analyst

    1010 Analog Devices Inc. • Wilmington, MA, United States
    Full-time +1
    NASDAQ : ADI ) is a global semiconductor leader that bridges the physical and digital worlds to enable breakthroughs at the Intelligent Edge. ADI combines analog, digital, and software technologie...Show more
    Last updated: 9 days ago • Promoted
    Director of Reimbursement

    Director of Reimbursement

    Northeast Rehabilitation Hospital Network • Salem, NH, US
    Full-time
    Director of Reimbursement & Decision Support.Responsible for the revenue budgeting, reimbursement, and financial analysis functions. Prepare annual and flexible budgets including maintenance of ...Show more
    Last updated: 16 days ago • Promoted
    Associate Director, CMC Operations

    Associate Director, CMC Operations

    Ardelyx • Waltham, MA, United States
    Full-time
    Ardelyx is a publicly traded commercial biopharmaceutical company founded with a mission to discover, develop and commercialize innovative first-in-class medicines that meet significant unmet medic...Show more
    Last updated: 14 days ago • Promoted
    Corp. Acct Director - HME, Northeast US

    Corp. Acct Director - HME, Northeast US

    MCKESSON • MA, United States
    Full-time
    McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare.We are known for delivering insights, products, and services that make quality care more accessibl...Show more
    Last updated: 25 days ago • Promoted
    Supplier Quality Engineer

    Supplier Quality Engineer

    The Panther Group • Franklin, MA, US
    Full-time
    Support MRB process for supplier materials.Investigate trends and issue timely corrective action requests to suppliers to resolve discrepant material issues and determine root causes.Assure supplie...Show more
    Last updated: 9 days ago • Promoted
    Quality Engineer II

    Quality Engineer II

    Careers Integrated Resources Inc • Mansfield, MA, US
    Full-time
    Job Title : Quality Engineer II.Location : Onsite - Mansfield, MA 02048.Duration : 6 + months W2 contract with high possibility of extension based on performance and business needs.The Quality Systems...Show more
    Last updated: 27 days ago • Promoted
    Chief Medical Officer - Tufts Medicine Behavioral Health Hospital

    Chief Medical Officer - Tufts Medicine Behavioral Health Hospital

    Tufts Medicine • Burlington, MA, US
    Full-time
    Tufts Medicine, a leading integrated academic health system in Massachusetts, and Acadia Healthcare, the nations largest standalone behavioral health provider, have partnered to establish the Tufts...Show more
    Last updated: 22 hours ago • Promoted • New!
    Quoting Specialist

    Quoting Specialist

    Element Materials Technology • Acton, MA, United States
    Full-time
    Join Element's Acton laboratory, a cGMP-certified, FDA- and DEA-registered facility specializing in microbiology, environmental monitoring, and compliance testing for sterile compounding and drug m...Show more
    Last updated: 30+ days ago • Promoted
    Quality Assurance Associate II (Scientific)

    Quality Assurance Associate II (Scientific)

    Pyramid Consulting, Inc • Framingham, MA, US
    Temporary
    Quality Assurance Associate II (Scientific).Please review the job description below and contact me ASAP if you are interested. Employee benefits include, but are not limited to, health insurance (me...Show more
    Last updated: 23 days ago • Promoted
    OB / GYN Hospitalist

    OB / GYN Hospitalist

    Ballad Health • Norton, US
    Full-time
    Ballad Health Medical Associates (BHMA).Women’s Health program in Norton, Virginia.This location is anticipating more than 300 deliveries this year. Our OB Hospitalist team is made up of talented-ca...Show more
    Last updated: 30+ days ago • Promoted
    Histocompatibility Lab Director

    Histocompatibility Lab Director

    American Red Cross • Dedham, MA, United States
    Full-time
    As one of the nation's premier humanitarian organizations, the American Red Cross is dedicated to helping people in need throughout the United States and, in association with other Red Cross networ...Show more
    Last updated: 30+ days ago • Promoted
    Director, Internal Audit

    Director, Internal Audit

    Entegris • Billerica, MA, United States
    Temporary
    Here at Entegris, we use advanced science to enable technologies that transform the world, and we are seeking employees who have the drive to continue that mission. Vice President of Internal Audit ...Show more
    Last updated: 30+ days ago • Promoted