- Job Type: Full-Time
- Function: Engineering QA
- Industry: Healthcare IT & Services
- Post Date: 01/07/2026
- Website: www.centaurihs.com
- Company Address: 16260 North 71st Street Suite 325, Scottsdale, AZ 85254
About Centauri Health Solutions
Centauri Health Solutions is a healthcare technology and services company driven by our desire to make the healthcare system work better for our clients and to provide compassionate support for individuals in need.Our analytics-powered software enables hospitals and health plans (Medicare, Medicaid, Exchange and Commercial) to manage their variable revenue through a custom-built workflow platform. While our tailored support of their patients and members provides them with access to life-enhancing benefits.
Job Description
Role Summary:
The Coding Quality Specialist conducts coding quality reviews on internal and external coders to ensure diagnoses are appropriately and accurately assigned based upon clinical documentation, ICD-10-CM Official Guidelines for Coding and Reporting, AHA Coding Clinic Guidance, CMS program guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The Coding Quality Specialist will apply guidance provided for the medical record code abstraction primarily for Medicaid lines of business (Complete Code Capture), but may also include Medicare Advantage Risk Adjustment or Commercial Risk Adjustment.
Role Responsibilities:
- Perform coding quality reviews of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation
- Provide formal reports on audit findings and conduct education to internal and external coders based upon those findings
- Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations
- Ability to pass coding quiz with 80% accuracy
- Consistently maintain a minimum 95% accuracy on audits by coding leadership
- Meet minimum productivity requirements as outlined by the project terms
- Ability to adhere to client guidelines when superseding other guidelines
- Assist coding leadership by making recommendations for process improvements to further enhance coding goals and outcomes
- Handle other related duties as required or assigned
Role Requirements:
- Minimum of 3 recent years of production coding experience in Retrospective Risk Adjustment coding (must be within last 6 months)
- Minimum of 2 years experience conducting coder audits in the Risk Adjustment environment
- Required code set knowledge and coding experience in Medicaid (primary), Medicare, Commercial Minimum of 1 year coding experience with Complete Code Capture
- Minimum of 5 years certified with a core coding credential from AHIMA or AAPAHIMA – CCS, CCS-P, AAPC – CPC, CRC (no apprentice credentials accepted)
- Strong organizational skills
- Technical savvy with high level of competence in basic computers, Microsoft Outlook, Word, and Excel
- Strong written and verbal communication skills
- Ability to work independently in a remote environment