Anthem Medical Records Auditor & Training Consultant - Any US (CPC Certification Required) - 129295 in Boston, Massachusetts

/Your Talent. Our Vision/. AtAnthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we willdrive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Medical Records Auditor & Training Consultant(Medicare Risk Adjustment)


  • Location: *Work@Home Preferred location is Worthington, Ohio, however, the selected candidate may be in any US location.

    The Medical Records Auditor & Training Consultant performs audits by evaluating medical records to ensure risk mitigation and to ensure compliance with CMS, ICD-10-CM coding guidelines, and medical record documentation requirements. This position is also responsible for developing coding training materials where appropriate. Primary duties include:

    • Collection and analysis of data to formulate recommendations and solutions based on audit trends and results.

    • Provides regular feedback to leadership on performance improvement opportunities as a result of performance gaps.

    • Serves as coding subject matter expert to internal and external stakeholders.

    • Assists the business with research and develops training materials as appropriate.

    • Assists the business with documentation of workflows and appropriate policies and procedures.

    • Requires a Bachelor’s degreeorany combination of education and experience, which would provide an equivalent background.

    • Requires a coding certification (/e.g.,/Certified Coding Associate or Certified Professional Coder) from an accredited source (e.g., American Health Information Management Association or American Academy of Professional Coders). Certified Risk Adjustment Coder– a plus.

    • 5 years of experience of relevant coding and/or medical record audit experience. Audit experience can be in a physician’s office, hospital or insurance office setting.

    • Experience developing educational materials is preferred.

    • Medicare Risk Adjustment experience preferred.

    • Proficient with MS Office applications: Word PowerPoint, Excel preferred.

/ Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2016 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran. /

Job Medical

Title: Medical Records Auditor & Training Consultant - Any US (CPC Certification Required) - 129295

Location: massachusetts-Boston

Requisition ID: 129295