Coding Quality Auditor

Providence

. Conduct detailed diagnostic chart reviews of clinical documentation and coding associated with Risk Adjustment and HCC coding .

Posted 10/15/2026full-timeRemote • Washington • United StatesJuniorMid-Level💰 $37 - $58 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in HCC coding and compliance with Official Coding Guidelines, ensuring accurate documentation and coding for risk adjustment. Proficient in medical billing and reimbursement processes, with a focus on quality integrity and regulatory oversight.

Highest-signal resume keywords

HCC CodingCertified Professional Coder (CPC)Certified Risk Adjustment Coder (CRC)Medical BillingCompliance with Official Coding Guidelines

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Diagnostic Chart ReviewCoding AbstractionQuerying ProvidersDocumentation ReviewRVU Capture

Certifications & Qualifications

Certified Professional Coder (CPC)Certified Coding Specialist (CCS)Certified Risk Adjustment Coder (CRC)Certified Professional Medical Auditor (CPMA)Certified Healthcare Compliance Auditor (CHCA)

Industry Keywords

Medical Insurance ReimbursementCharge ReviewPatient Account InformationInsurance Explanations of BenefitsFinancial Records

About the role

Key responsibilities & impact

Conduct detailed diagnostic chart reviews of clinical documentation and coding associated with Risk Adjustment and HCC coding
Review and abstract HCC codes for accurate, highly specific coding
Query providers to clinically validate or clarify diagnosis criteria
Review documentation for compliant reporting, billing, and RVU capture
Serve as a coding expert
Work with the Quality Integrity Program manager and clinical documentation review team
Ensure compliance with Official Coding Guidelines for Coding and Reporting, coding conventions, and regulatory oversight requirements

Requirements

What you’ll need

2 years of experience in medical insurance reimbursement, medical billing, and coding related to charge review and work RVUs
Experience reviewing patient account information, insurance explanations of benefits, computer screens, and financial records
Within 1 year of hire: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
Bachelor's degree preferred, or equivalent education/experience
Within 1 year of hire: Certified Risk Adjustment Coder (CRC) preferred
Within 1 year of hire: Certified Professional Medical Auditor (CPMA) or Certified Healthcare Compliance Auditor (CHCA) preferred
Experience in HCC coding preferred

Benefits

Comp & perks

Retirement 401(k) Savings Plan with employer matching
Health care benefits (medical, dental, vision)
Life insurance
Disability insurance
Paid parental leave
Vacation and holiday time off
Health-related time off benefits
Voluntary benefits
Well-being resources
Inclusive workplace and equal opportunities for advancement