What are the responsibilities and job description for the Coding Auditor Sr position at elevancehealth?
Job ID: JP00046713
Anticipated Start Date: August 17, 2026
Please note this is the target date and is subject to change. BCForward will send official notice ahead of a confirmed start date.
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Responsible for auditing diagnosis data collected from physician and hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements.
Primary duties may include, but are not limited to:
Audits diagnosis data retrieved from physician and hospital medical records and/or data extract files for both revenue project and RADV.
Assists with National and Targeted Risk Adjustment Data Validation audits.
Participates and represents the department in business leadership groups.
Serves as a subject matter exert.
Assesses and identifies training opportunities.
Maintains current knowledge of requirements and guidance required in the performance of audit duties.
Requirements:
Requires a H.S. diploma or equivalent and minimum of 3 years of experience as coder of medical records in physician office, hospital, or insurance/coding office setting; or any combination of education and experience, which would provide an equivalent background.
BS in health sciences, health management or related field preferred. Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) required.
Experience working with Medicare Advantage preferred. Experience with ICD-9 coding a plus.
Job Type: Contract
Additional Details:
Work schedule: Monday- Friday, 8am-5pm (CST)
HCC coding preferred.
Must be a certified medical coder (CPC) and preference given to Certified Risk Adjustment Coders (CRC).
Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, contractors are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
About BCForward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.
BCForward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.
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