Posted Jul 12, 2026

Quality Review and Audit Analyst, Individual & Family Plans

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Job Description: • conduct medical records reviews with accurate diagnosis code abstraction • utilize HHS’ Risk Adjustment Model • apply longitudinal thinking for data capture • perform various documentation and data audits • collaborate with team members and matrix partners • coordinate with stakeholders to execute RA programs • communicate effectively across all audiences • develop and implement internal program processes Requirements: • high school diploma • at least 2 years’ experience in coding certifications • experience with medical documentation audits • proficiency with ICD-10-CM coding guidelines • familiarity with CMS regulations for Risk Adjustment programs • HCC coding experience preferred • computer competency with excel, MS Word, Adobe Acrobat • detail oriented • self-motivated • excellent organization skills • understanding of medical claims submissions preferred Benefits: • medical • vision • dental • well-being and behavioral health programs • 401(k) • company paid life insurance • tuition reimbursement • a minimum of 18 days of paid time off per year • paid holidays Apply Now Apply Now