{"id":2674337,"url":"https://alion.io/job/wakely-hcc-coderauditor","title":"HCC Coder/Auditor","company":{"id":2950056,"name":"Wakely","domain":"wakely.com","url":"https://alion.io/company/wakely","size_band":"501-1000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"iCIMS","truth_index":null},"role":"Finance","role_family":"Finance","seniority":"senior","employment_type":null,"work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":{"min_usd":81000,"max_usd":155000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":4389},"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false},{"name":"Microsoft Office","optional":false}],"status":"live","first_seen_at":"2026-10-16T04:37:27Z","employer_posted_date":"2026-10-16","last_verified_at":"2026-10-17T19:15:21Z","board_verified":true,"closed_at":null,"days_open":1,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":1},"description":"Overview\nJob Summary\nThe HCC Coder/Auditor reviews, codes, and audits medical records to ensure accurate risk adjustment reporting and compliance with CMS Risk Adjustment requirements, ICD-10-CM Official Coding Guidelines, and client-specific standards.\nThis position communicates coding findings and documentation improvement opportunities to clients, leadership, and internal teams; maintains audit-ready records; supports education and quality initiatives; and completes retrospective, prospective, and other Medicare Advantage or Risk Adjustment activities as assigned.\nResponsibilities\nWork Performed and Job Requirements\nCoding, Auditing, and Quality ReviewDetermine daily assignments through established department and project processes.\nAccess designated client systems to review and code medical records for HCC and Risk Adjustment projects using CMS requirements, ICD-10-CM Official Coding Guidelines, and client-specific standards.\nPerform coding audits and quality reviews to validate diagnosis-code accuracy and documentation support.\nIdentify undercoded, overcoded, unsupported, and missed diagnoses; document findings and provide clear oral or written coding rationale.\nSupport retrospective and prospective reviews and other Medicare Advantage or Risk Adjustment activities as assigned.\n\nClient Engagement & Documentation ImprovementCommunicate coding findings, trends, and documentation improvement opportunities to clients, management, and internal teams.\nPrepare and present client and internal education, quality, and coding presentations as requested.\n\nOperational & Compliance SupportComplete client spreadsheets, databases, audit tools, and other tracking documentation accurately and timely.\nMaintain established productivity and quality standards and update accurate productivity and quality records.\nRecord time and project activities accurately in designated timekeeping systems.\nFollow department policies, client instructions, HIPAA requirements, confidentiality standards, and established workflows.\nRemain current on CMS Risk Adjustment regulations, RADV requirements, ICD-10-CM guidelines, Coding Clinic guidance, and relevant industry practices.\nMaintain current MARSI and client-system access and report access issues, IT concerns, and system outages through established ticket processes.\nWork weekends or holidays when required by client demands.\n\nQuality Improvement & EducationParticipate in internal quality assurance, education, and continuous-improvement activities.\nAssist with development, editing, and periodic quality and content reviews of company school curricula, training materials, articles, and coding resources.\n\nOther DutiesAll other duties as assigned.\n\nQualifications\nEducation/Training\nMinimum of a High School Diploma or equivalent and Certified Risk Adjustment Coder (CRC) certification through AAPC. Certification must remain current and in good standing.\nCPC, CCS, CCS-P, RHIT, or RHIA certification; Associate’s or bachelor’s degree in health information management or a related healthcare field preferred.\nExperience\nMinimum of 5 years of medical coding experience, including at least 3 years of HCC Risk Adjustment coding and/or auditing experience. Experience with Medicare Advantage and CMS Risk Adjustment programs, RADV, retrospective reviews, prospective reviews, and quality assurance activities preferred.\nKnowledge, Skills and Abilities\nStrong knowledge of ICD-10-CM coding guidelines, conventions, and documentation requirements supporting risk-adjusted diagnoses.\nKnowledge of CMS Risk Adjustment methodology, HCC coding principles, and medical terminology, anatomy, physiology, disease processes, and pharmacology.\nAbility to read, analyze, and interpret complex medical records and determine accurate code assignment using official guidelines.\nAbility to identify coding trends, documentation opportunities, compliance concerns, and process-improvement opportunities.\nStrong written and verbal communication skills in the English language, including the ability to explain coding rationale clearly.\nProficiency with Microsoft Office applications, electronic health records, coding software, databases, spreadsheets, and web-conferencing tools.\nExcellent organization, attention to detail, prioritization, deductive reasoning, and ability to meet deadlines.\nAbility to work independently while maintaining productivity, quality, integrity, confidentiality, and professional-development expectations\nEEO\nEqual Opportunity Employer/Protected Veterans/Individuals with Disabilities\nThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)\nAdditional Info","description_format":"text","description_chars":5356,"description_truncated":false,"requirements":{"experience_years_min":5,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"high_school","optional":true},"security_clearance":false,"languages":[{"language":"English","level":"All levels","optional":false}]},"benefits":[],"hiring_locations":[],"hiring_excludes":[],"relocation_offered":false,"industries":[],"lifecycle":[{"event":"open","at":"2026-10-16T04:37:27Z"}],"visa":[],"liveness":{"score":86,"band":"hot","label":"Hiring now","p_open":1,"p_active":0.86,"p_room":1,"age_days":1,"expected_fill_days":38,"reasons":["conf:3","win:early"],"computed_at":"2026-10-17T05:46:00Z"},"pay":null,"html_url":"https://alion.io/job/wakely-hcc-coderauditor","json_url":"https://alion.io/job/wakely-hcc-coderauditor.json","meta":{"generated_at":"2026-10-17T19:30:42Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":30573,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-18T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":2950056},"rest":"https://alion.io/mcp/rest/get_company?id=2950056"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fwakely-hcc-coderauditor"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fwakely-hcc-coderauditor"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fwakely-hcc-coderauditor"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/wakely-hcc-coderauditor\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fwakely-hcc-coderauditor"}]}