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Sr. Medical Quality Auditor Risk Adjustment
GuideWellFlorida, United States
Posted April 2, 2026
71800 - 115700 USD
Full Time
About the Company
GuideWell Mutual Holding Corporation is a not-for-profit mutual holding company dedicated to transforming healthcare through innovation and collaboration. The company offers health insurance, consumerism services, new care delivery models, and health innovation initiatives, aiming to provide integrated solutions that enhance patient experiences and drive efficiency in the industry.
Job Description
The Sr. Medical Quality Auditor Risk Adjustment will perform quality accuracy audits for internal and external coders to ensure consistency and accuracy of ICD-10 coding. The role will assist leadership with audit processes, identify trends, and provide training and education.
Requirements
- 4+ years related work experience in Risk Adjustment Coding, Auditing, Coding Accuracy, and/or Provider Education
- CRC (Certified Risk Adjustment Coder from AAPC) certification
- At least one of the following certifications: CPC, COC, CIC, CCS, CCS-P
- Excellent communication and collaboration skills
- Knowledge of health plan operations and provider operations
Benefits
- Medical, dental, vision, life, and global travel health insurance
- Income protection benefits: life insurance, short- and long-term disability programs
- Leave programs to support personal circumstances
- Retirement Savings Plan with employer match
- Paid time off, volunteer time off, 10 holidays, and 2 well-being days