Auditor

• Conduct provider medical record audits
• Analyze practice coding patterns
• Provide education and training regarding risk adjustment
• Analyze MRA data to identify patterns and develop interventions at provider and market levels
• Coordinate an educational work plan for WellCare contracted providers
• Work with Provider Relations, Quality, and the state Medical Director to ensure compliance with CMS risk adjustment guidelines
• Conduct provider education and training through provider offices, hospitals, webinars, conference calls, and email correspondence
• Work on additional risk adjustment audit requests, including outside auditors’ requests
• Serve as a subject matter expert on the RADV Committee
• Perform quality assurance auditing of ICD-9/ICD-10 coding for WellCare’s Medical Coding Specialists
• Communicate QA results and recommend improvement and retraining topics
• Perform other duties as assigned
• Comply with all policies and standards

Explore Risk Adjustment Auditor – Educator at Centene Corporation. Review requirements and application details.