Medicare Risk Adjustment Compliance Auditor (CPC, CCS, or CCS-P Required)

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first.We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Remote Risk Adjustment Compliance Auditor is to conduct provider and coder level reviews and audits to ensure accurate risk adjustment data is being submitted to the CMS. Develops and maintains tracking tools, reviews and audits outcomes / findings and monitors any corrective active plans implemented due to review or audit findings. Monitors internal reporting for outliers, stays up to date with CMS audit processes and actively participates in all audits as they relate to risk adjustment. Job Duties/Responsibilities: 1. Monitors coding prevalence reporting for coding outliers. 2. Reviews IPA Policies and procedures to ensure programs are compliant. 3. Monitors internal coding staff accuracy percentages to ensure they are tracked and maintained. 4. Monitors coding vendor’s accuracy percentages to ensure the coding accuracy and quality of th