Coding Auditor Sr

JR171732 Coding Auditor Sr

Location: Virtual. This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Hours: 8:00 a.m. – 5:00 p.m., Monday – Friday.

How You Will Make An Impact

• Audit coders that retrieve diagnosis data from physician and hospital medical records and/or data extract files for both revenue project and RADV.
• Assist with National and Targeted Risk Adjustment Data Validation audits.
• Participate and represent the department in business leadership groups.
• Serve as a subject matter expert.
• Assess and identify training opportunities.
• Maintain current knowledge of requirements and guidance required in the performance of audit duties.

Minimum Requirements

• High school diploma or equivalent and a minimum of 3 years of experience as a coder of medical records in a physician office, hospital, or insurance/coding office setting; or any combination of education and experience that provides an equivalent background.

Preferred Skills, Capabilities, And Experiences

• Medical Coder certification from an accredited source (e.g., AHA, AAPC, PMI).
• Experience working with Medicare Advantage and Medicaid preferred.
• Experience with ICD-10 coding, CPT and CPT-II a plus.
• HCC coding preferred.
• CPC or CRC Certification is required for this position.
• Familiarity with electronic indexes is highly preferred.
• Experience with telehealth visits is preferred.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, paid time off, incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short- and long-term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process may contact elevancehealthj for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.