Description
About e4health
At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do:
Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth.
Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day.
WE GROW: We believe in win/win outcomes—when our customers win, we win.
GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions.
Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully.
POSITION TITLE:
Senior HCC Auditor
ROLE TYPE:
Full Time 40 hours
EMPLOYMENT TYPE:
Non-Exempt
JOB SUMMARY:
The HCC Auditor is responsible for completing quality assurance reviews on internal or external coders/providers/accounts following the official ICD-10-CM and appropriate Risk Adjustment guidelines. This role will be responsible for reviewing a patient’s medical record and validating the assignment of HCC codes (and possibly complete code capture) for completeness and accuracy. The HCC Auditor also plays a key role in reporting quality results, tracking and trending of educational opportunities, responding to client subject matter needs, and providing educational support and training to coders and/or providers.
The HCC Auditor is expected to maintain a consistent auditing accuracy rate of 95% or better while also meeting agreed upon productivity standards.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Completes all regularly scheduled quality assurance reviews for clients
Knowledge of health systems operations, including an understanding of reimbursement methodologies and coding conventions
Advanced knowledge and understanding of HCC/risk adjustment, coding and documentation requirements
Demonstrate ability to perform accurate and complete chart audits for HCC/risk adjustment
Demonstrated ability to identify and communicate trends in provider coding and documentation
Excellent written, verbal, communication, and attention to detail skills
Ensures all diagnoses are accurate and complete from the medical record in accordance with ICD-10 CM Guidelines for Coding and Reporting
Confirms the correct code to the highest level of specificity as documented in the medical records
Works effectively and efficiently within a team environment
Complies with policies and procedures for confidentiality of all patient records and security of systems
Maintains required productivity and quality requirements
Maintains coding credential requirements
BENEFITS:
We offer an excellent salary, full benefits package including 401(k) with company match, medical, dental, vision, life, short/long term disability insurance, and PTO policy.
PHYSICAL DEMANDS OF THE ESSENTIAL FUNCTIONS:
This role requires prolonged periods of desk working on a computer
Talking, hearing, and near vision are required to perform computer-based tasks and virtual communication
Sensory perception (visual, auditory, and tactile) is essential for computer and phone use
WORKING CONDITIONS WHILE PERFORMING ESSENTIAL FUNCTIONS:
This is a remote role; the majority of the work is performed in a home office environment, except when traveling to field sites.
e4health is an equal opportunity employer and will consider all applications without regard to race, color, religion, national origin, ancestry, marital status, veteran status, age, disability, pregnancy, genetic information, gender, sexual orientation, gender identity or any other legally protected category.
Applicants for U.S. based positions with e4health must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Visa sponsorship is not available for this position.
Requirements
REQUIRED QUALIFICATIONS:
Candidate must possess an approved AHIMA or AAPC coding credential - CRC (Certified Risk Adjustment Coder) preferred
Candidate must have held their credential for 7+ years
Minimum 7 years’ coding experience required
40 hour per week commitment preferred
HCC coding experience required
Can not have coded BY 2025 ACA or HHS charts
Must be available for entire project (Jan-April 2027)
Must have at least 7 years of relevant professional experience while living and working in the United States.
KEY SUCCESS ATTRIBUTES:
Demonstrates strong communication and collaboration skills
Has strong organizational, analytic and problem-solving abilities and techniques
Exhibit consistent initiative with strong drive for results and success
Demonstrate commitment to a team environment
Demonstrate excellent interpersonal as well as well-developed written and verbal communication skills, including deep listening and attention to detail
Possess strong time management skills
Commitment and adherence to company Core Values
CORE COMPETENCIES:
High level of integrity & ethical judgement
Communication
Consistency and Reliability
Meeting Standards