HCC QA Reviewer

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. 

As our HCC QA Reviewer, you will help ­­ensure the accuracy and quality of Hierarchical Condition Category (HCC) coding and documentation

Every day you will use your attention to detail, obsession with accuracy, and analytical and problem solving skills to perform audits, provide feedback, and ensure compliance with national coding guidelines and industry regulations To thrive in this role you must be able to work independently to achieve deadlines and meet production goals, have an active coding certification from AAPC or AHIMA with work experience as an HCC coder with auditing experience.

Here’s what you will experience working as an HCC QA Reviewer:

• Conduct internal coding audits of HCC coding reviews ensuring compliance with national coding guidelines and industry regulations

• Identify discrepancies in coding and documentation; implement corrective actions and provide feedback and training to the coding team to improve accuracy and efficiency.

• Maintain up-to-date knowledge of HCC coding guidelines and industry best practices.

• Collaborate with the risk adjustment team to ensure accurate and compliant coding practices; participate in continuous quality improvement initiatives.

• Prepare detailed audit reports and present findings to management.

Required Skills:

• You have an active coding certification from AAPC or AHIMA (CPC, CCS, RHIT, RHIA)

• You know the ins and outs of ICD-10 coding and HCC risk adjustment models and guidelines through years of work experience in medical coding and auditing

• You are confident in your ability to navigate electronic health records and coding software

• You know healthcare compliance and regulatory requirements

For this US-based position, the base pay range is $18.16 - $31.13 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.

R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.

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To learn more, visit: R1RCM.com

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