QHP Coding Auditor

A company is looking for a QHP Coding Auditor (REMOTE).

Key Responsibilities

Conduct initial chart reviews and coding quality audits to validate ICD-10-CM code accuracy

Abstract and audit codes for QHP (RADV) projects, ensuring documentation supports coding decisions

Apply state, federal, and CMS documentation requirements consistently across all assignments

Required Qualifications

Active AHIMA or AAPC certification (e.g., RHIT, CCS, CCS-P, CPC, CIC); CRC strongly preferred

Minimum 7 years of coding experience, including 5+ years in Risk Adjustment (RADV experience required)

Proficiency with Microsoft Office Suite and coding software or encoders

Must have a secure, private workspace compliant with PHI confidentiality standards