Coding Auditor Sr. (CareBridge)

Anticipated End Date: 2026-08-07 Position Title: Coding Auditor Sr. (CareBridge) Job Description: Coding Auditor Sr. CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through homecare and community-based services. LOCATION : This is a virtual eligible role. You should be within a reasonable proximity to one of our offices. HOURS : 8:00a - 5:00p, Monday through Friday (Eastern or Central time) Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. 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.

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. Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) required Preferred Qualifications Previous auditing experience is a must for this role! BS preferred. CRC certification preferred. Experience working with Medicare is preferred. Experience with ICD-9 coding a plus. Job Level: Non-Management Non-Exempt Workshift: Job Family: MED > Licensed/Certified - Other Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

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. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources,