14 days old

Risk Adjustment Auditor

Kelly Services
Clayton, MO 63105
Kelly Services is currently seeking a Risk Adjustment Auditor for one of our top clients in **Clayton, MO!**

**Pay** : $27-$29/hr.

**Essential Functions:**

+ Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Tenth Revision (ICD-10). Always coding to the highest level of specificity.

+ Follows the Official ICD-10 guidelines

**Job Summary:**

Performs quality assurance of ICD-10 auditing of WellCare's Medical Coding Specialists and external vendors that submit risk adjustment data based on medical record reviews. Subject Matter Expert (SME) in the Risk Adjustment Data Validation (RADV) auditing process, all internal and/or external audits for both Medicare and Medicaid.

Performs quality assurance auditing (i.e. ensure appropriateness and accuracy of ICD-10 coding) for WellCares Medical Coding Specialists;

Accountable for communicating QA results to the Medical Coding Specialists with suggestions for improvement and re-training topics;

Responsible for auditing external vendors coding based on medical record reviews;

Responsible for conducting all activities in relation to CMS RADV audits: medical record review, identifying best medical record, submitting all necessary paperwork, transmitting data to CMS, responding to all inquiries, and providing expertise and support during the appeals process;

Works on additional risk adjustment audit requests (i.e. outside auditors requests).

Serves on the RADV Committee as subject matter experts.

Perform other duties as necessary.


+ Required A High School or GED

+ Preferred An Associate's Degree in a related field


+ Required 5+ years of experience in professional coding either in a hospital or physician setting

+ Preferred Other Managed Care experience

**Licenses and Certifications:**

_A license in one of the following is required:_

+ Required Certified Professional Coder (CPC)

+ Preferred Certified Coding Specialist (CCS)"

**Were hiring, and were here to help you figure out what's next. Please include a copy of your resume and email Kendyl at today to get started**

**Why Kelly** **** **?**

As a worker today, its up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping you find whats next is what were all about. We know whats going on in the evolving world of workjust ask the nearly 500,000 people we employ each year. Connecting with us means getting the support, guidance, and opportunities needed to take your career where you may have never imagined.

**About Kelly** ****

At **Kelly** , were always thinking about whats next and advising job seekers on new ways of working to reach their full potential. In fact, were a leading advocate for temporary/nontraditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety of workstyles, skill levels, and industries around the world.

Kelly is an equal opportunity employer committed to employing a diverse workforce, including, but not limited to, minorities, females, individuals with disabilities, protected veterans, sexual orientation, gender identity. Equal Employment Opportunity is The Law.

Posted: 2020-10-16 Expires: 2020-11-16

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Risk Adjustment Auditor

Kelly Services
Clayton, MO 63105

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