QA Risk ADj Auditor II
Medford, OR · On-site +1
... or auditing or equivalent combination of education and experience. Risk Adjustment, HCC or ... Demonstrated ability to perform accurate and complete chart reviews for risk adjustment.
QA Risk ADj Auditor II
Medford, OR · On-site +1
... or auditing or equivalent combination of education and experience. Risk Adjustment, HCC or ... Demonstrated ability to perform accurate and complete chart reviews for risk adjustment.
QA Risk ADj Auditor II
Portland, OR · On-site +1
... or auditing or equivalent combination of education and experience. Risk Adjustment, HCC or ... Demonstrated ability to perform accurate and complete chart reviews for risk adjustment.
QA Risk ADj Auditor II
Portland, OR · On-site +1
... or auditing or equivalent combination of education and experience. Risk Adjustment, HCC or ... Demonstrated ability to perform accurate and complete chart reviews for risk adjustment.
Coder
$18.75 - $25/hr
The Coder manages the day to day responsibilities of chart abstraction, vendor auditing and ... remote work · Competitive salaries · Excellent benefits Responsibilities · Perform code ...
Coder
$18.75 - $25/hr
The Coder manages the day to day responsibilities of chart abstraction, vendor auditing and ... remote work · Competitive salaries · Excellent benefits Responsibilities · Perform code ...
Quality Compliance Specialists
Salem, OR · Remote
$21.82 - $42.55/hr
Specialist, Quality Interventions/QI Compliance (Remote) Application Deadline: Open Until Filled ... Operational knowledge and experience with Excel and Visio (flow chart equivalent). Preferred ...
Quality Compliance Specialists
Salem, OR · Remote
$21.82 - $42.55/hr
Specialist, Quality Interventions/QI Compliance (Remote) Application Deadline: Open Until Filled ... Operational knowledge and experience with Excel and Visio (flow chart equivalent). Preferred ...
Remote Chart Auditing information
What is remote chart auditing?
Remote chart auditing is the process of reviewing and analyzing medical records and patient charts from a remote location, often using secure digital systems. Chart auditors typically check for accuracy, compliance with regulations, proper documentation, and adherence to coding standards. This ensures that healthcare providers maintain accurate records for billing, legal, and quality assurance purposes. Remote chart auditors may work for hospitals, insurance companies, or third-party auditing firms.
What are the key skills and qualifications needed to thrive as a remote chart auditor, and why are they important?
To thrive as a Remote Chart Auditor, you need in-depth knowledge of medical coding, billing practices, healthcare regulations (such as HIPAA), and a relevant credential like RHIA, RHIT, or CPC. Proficiency with electronic health record (EHR) systems, auditing software, and coding tools like ICD-10-CM and CPT is essential. Strong attention to detail, analytical thinking, and effective written communication set top performers apart in this role. These skills ensure accurate audits, regulatory compliance, and effective identification of documentation or coding errors, which are critical for healthcare organizations.
What are some common challenges faced by professionals in remote chart auditing roles, and how can they be managed effectively?
Remote chart auditors often encounter challenges such as limited access to on-site resources, varying documentation standards across healthcare providers, and the need to maintain data security. To manage these effectively, auditors should develop strong communication skills to clarify discrepancies with healthcare staff, stay updated on compliance regulations, and utilize secure, HIPAA-compliant software. Additionally, setting up a dedicated, distraction-free workspace and adhering to a structured review process can help maintain accuracy and productivity when working remotely.
What is the difference between Remote Chart Auditing vs Remote Medical Coding?
| Aspect | Remote Chart Auditing | Remote Medical Coding |
|---|---|---|
| Credentials | Certifications like CPC, CCS, or RHIT often preferred | Certifications like CPC, CCS, or RHIT required |
| Work Environment | Reviewing patient records remotely for accuracy and compliance | Assigning medical codes to diagnoses and procedures remotely |
| Industry Usage | Used in healthcare compliance, billing accuracy, and quality assurance | Used in billing, reimbursement, and insurance claims processing |
Remote Chart Auditing and Remote Medical Coding share similar credentials and work environments, often requiring CPC or CCS certifications. However, chart auditors focus on reviewing records for accuracy and compliance, while medical coders assign codes for billing purposes. Both roles are essential in healthcare revenue cycle management and are commonly performed remotely.
How to become a remote chart auditor?
To become a remote chart auditor, typically you need a background in healthcare, such as a medical coding or billing certification, and experience with medical records. Strong attention to detail, knowledge of coding standards like ICD and CPT, and proficiency with auditing tools or electronic health record systems are essential. Many roles also require good communication skills and the ability to work independently in a remote environment.
What are the most commonly searched types of Chart Auditing jobs in Oregon?
The most popular types of Chart Auditing jobs in Oregon are:
What are popular job titles related to Remote Chart Auditing jobs in Oregon?
For Remote Chart Auditing jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Remote Chart Auditing jobs in Oregon look for?
The top searched job categories for Remote Chart Auditing jobs in Oregon are:
What cities in Oregon are hiring for Remote Chart Auditing jobs?
Cities in Oregon with the most Remote Chart Auditing job openings:
QA Risk ADj Auditor II
Medford, OR • On-site, Remote
Cambia Health Solutions
• Health Care and Social Assistance • 1 - 5K employees1,001 - 5,000 employees
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 5 days ago
Cambia Health Solutions rating
8.4
Based on 32 frontline employees who took The Breakroom Quiz
Job description
Risk Adjustment Auditor I or II
Hybrid role (3 days/week in office) at our Salt Lake City, Boise, Fargo, Portland, Vancouver, Renton, Medford, Burlington, Lewiston offices. Preference will be given to current employees and candidates who reside within a commutable distance from our Salt Lake City, Boise, Fargo and Lewiston offices or who are willing to relocate.
Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.
Who We Are Looking For:
Every day, Cambia's dedicated team of Risk Adjustment Auditor is living our mission to make health care easier and lives better. As a member of the Risk Adjustment team, our The Risk Adjustment Auditor performs Retrospective/Prospective chart review utilizing various types of records to ensure accurate risk adjustment reporting. Responsible for assisting in second level reviews of all new HCCs identified through the first pass chart review process. Identifies trends in provider coding/documentation and vendor risk adjustment reporting and makes those trends known to leadership as well as coding team manager and training lead to develop intervention strategies - all in service of creating a person-focused health care experience.
Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
Risk Adjustment Auditor I would have an Associate degree in Healthcare or related field and one year of experience in clinical coding or auditing or equivalent combination of education and experience. Risk Adjustment, HCC or Inpatient coding experience required.
Risk Adjustment Auditor II would have an Associate degree in Healthcare or related field and three years of experience in clinical coding or auditing or equivalent combination of education and experience. Risk Adjustment, HCC or Inpatient coding experience required.
Required Licenses, Certifications, Registration, Etc.
CPC and CRC coding certification required
Skills and Attributes:
Demonstrated ability to perform accurate and complete chart reviews for risk adjustment.
Demonstrated ability to perform quality audits of internal and vendor coding.
Knowledge of and adherence to Official ICD-9-CM/ICD-10 Coding Guidelines.
Demonstrated analytical ability to identify problems, develop solutions, and implement actions in a timely manner.
Demonstrated ability to identify and communicate trends in provider and vendor coding and documentation.
Demonstrated proficient PC skills and familiarity with corporate software, such as Word, Excel and Outlook.
Effective verbal and written communication skills.
Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired
Additional Skills and Attributes for Risk Adj Auditor II
Knowledge of health systems operations, including an understanding of reimbursement methodologies and coding conventions for governmental and commercial products.
Advanced knowledge and understanding of risk adjustment, coding and documentation requirements.
Demonstrated ability to provide proactive and creative solutions to business problems.
What You Will Do at Cambia:
Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting.
Performs quality reviews of vendor coding in support of the risk adjustment process
Verifies and ensures the accuracy, completeness, specificity and appropriateness of provider-reported diagnosis codes based on medical record documentation.
Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC and HHS HCC categories.
Identifies trends in provider and vendor coding and documentation and partners with coding team manager and training lead to develop intervention strategies.
Supports and actively participates in process and quality improvement initiatives.
Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with requirements.
Consistently meets departmental performance and attendance requirements.
Additional Duties for Risk Adj Auditor II
Serves as a mentor to Risk Adjustment Auditor I staff.
Assists with special projects such as risk mitigation reviews.
Serves as subject matter resource regarding the risk adjustment process and diagnosis coding for risk adjustment.
Monitors and interprets regulatory changes that may impact administration of the Risk Adjustment Program. Assists with implementation activities as a result of regulatory changes to the Program.
Work Environment
Work primarily performed in office or remote environment.
Travel may be required, locally or out of state.
May be required to work overtime.
May be required to work outside normal hours.
Risk Adjustment Auditor I:
- Oregon, Utah, and Idaho:The expected hiring range is$57,800.00 - $78,200.00, the full salary range is54,000.00 - $89,000.00and the bonus target is5%.
- North Dakota:The full hourly range is$26.03 - $41.65 per hour.
Risk Adjustment Auditor II:
- Oregon, Utah, and Idaho:The expected hiring range is$69,700.00 - $94,300.00, the full salary range is$65,000.00 - $107,000.00and the bonus target is10%.
- North Dakota:The full hourly range is$28.70 - $45.93 per hour.
About Cambia
Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.
Why Join the Cambia Team?
At Cambia, you can:
- Work alongside diverse teams building cutting-edge solutions to transform health care.
- Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
- Grow your career with a company committed to helping you succeed.
- Give back to your community by participating in Cambia-supported outreach programs.
- Connect with colleagues who share similar interests and backgrounds through our employee resource groups.
We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.
In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:
- Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
- Annual employer contribution to a health savings account.
- Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
- Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
- Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
- Award-winning wellness programs that reward you for participation.
- Employee Assistance Fund for those in need.
- Commute and parking benefits.
Learn more about our benefits.
We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.
As part of our security requirements, new hires will need access to a personal mobile device to set up Multi-Factor Authentication (MFA) upon joining the company. MFA is an important layer of protection for accessing Cambia systems and is required for all employees.
We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.
If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
What Cambia Health Solutions employees say
Pay
Benefits
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Workplace
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About Cambia Health Solutions
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Portland, OR, US
Year founded
1996