HCC Risk Adjustment Quality Auditor

Responsibilities

• Perform quality reviews on internal and subcontracted outpatient CDI staff using HCC expertise
• Use audit tools to analyze quality results and track overall quality
• Prepare and deliver customized training on HCC documentation requirements for providers and coders
• Assess chart reviews for missed documentation or query opportunities impacting RAF scores
• Review charts to ensure clinical documentation supports MEAT requirements and identify documentation gaps
• Provide staff education based on audit findings and identify trends to improve HCC capture
• Collaborate with leadership to identify performance needs and create training programs

Requirements

• 2-5 years of experience in HCC auditing, outpatient CDI, Risk Adjustment, or related healthcare documentation
• Active RN or LPN license
• Proficiency in Epic workflows and management of OurPractice Advisories/OPAs
• Strong understanding of ICD-10 coding guidelines and HCC requirements
• Proficiency with MS Office, VPNs, virtual machines, and video conferencing tools

Preferred Qualifications

• CCDS, CCDS-o, CDIP, CDEO, or CRC certification

Benefits

• Full benefits package
• Paid Time Off (PTO)
• Opportunities for continuous learning and professional growth
• Collaborative, mission-driven environment

About the Company

UASI is driven by a mission to improve the quality and accuracy of clinical documentation through expert CDI consulting.