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MRA Coding Auditor - Remote

July 3, 2026

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.This is a remote position. The MRA Coding Auditor supports departmental Quality Assessment audits of internal Coding Analyst team and vendors to ensure accurate and complete data is submitted to CMS. Assists in Risk Adjustment related data audits (RAF, prevalence, clinical documentation improvement, P360, process) audits to identify areas of opportunity for improvement (training, data integrity, chart reviews).GENERAL DUTIES/RESPONSIBILITIES: 1. Supports regular quality assurance (QA) audits of internal Coding Analyst Team to validate and confirm coding & abstracting quality (95% HCC accuracy). These ongoing audits ensure coding quality & performance improvement standards are maintained, achieved & improved per department policies and procedures. 2. Tracks and reports progress of QA audits performed on the coding vendors to verify the coding accuracy and quality of the data submitted to AHP is accurate for submission to CMS. 3. Works with Risk Adjustment Management on any MRA data validation / coding audit to ensure completeness and coding accuracy of all submissions to CMS. This work may encompass reviews of data for reconciliation, data flow integrity, UAT testing, high cost / low risk score members, retrospective chart reviews, or other risk adjustment related data review as directed by Manager. 4. Analyzes and shares audit results with Manager. This information may be used for training physicians and clinical staff, documentation improvement, and system / process improvement. 5. Utilizes, protects, and discloses Alignment Healthcare patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. 6. Ensures compliance with all applicable federal, state &local regulations, as well as with institutional/organizational standards, practices, policies & procedures.7. Maintains professional / technical knowledge by attending appropriate educational workshops; reviewing professional publications; establishing personal networks; and participating in professional societies. Stay current of industry coding, compliance, and HCC issues. Required to maintain relevant continuing education units (CEUs) in relation to individual coding certifications. 8. Other duties as assigned to meet the organization’s needs.Job Requirements:Experience:• Required: Minimum three years of Medicare Risk Adjustment coding in a medical group or health plan setting required• Preferred:Education:• Required: High School Diploma or GED. Completion of a Medical Coding training program.• Preferred: Bachelor’s degree in Business Administration, health Care Management or in a related fieldTraining:• Required: Technical School or courses that are required to become a certified coder.Specialized Skills:• Required:<ul><li>Knowledge of</li><li>Proficient user in MS office suite – Excel, Word, Outlook</li><li>Previous use of Epic, Allscripts, EZCap</li><li>Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.</li><li>Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;</li><li>Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly</li><li>Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.</li><li>Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.</li><li>Report Analysis Skills: Comprehend and analyze statistical reports.</li></ul>Licensure:• Required: Certified Coder required, CCS, CCS-P, CPC, or CRCWork Environment:The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Essential Physical Functions:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.Pay Range: $64,384.00 - $96,577.00Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at <a href="https://protect-us.mimecast.com/s/P1GaC82l6KF8ygOUngCFQ/" target="_blank" rel="noopener noreferrer">https://reportfraud.ftc.gov/#/</a>. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email <a href="mailto:careers@ahcusa.com" target="_blank" rel="noopener noreferrer">careers@ahcusa.com</a>.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...