Remote opportunity at
Vera Whole HealthRisk Adjustment Quality Assurance (QA) Reviewer
Vera Whole Health has an opening for a remote, full-time Risk Adjustment Quality Assurance (QA) Reviewer. The job is the top operational authority in the risk…
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About This Role
Vera Whole Health has an opening for a remote, full-time Risk Adjustment Quality Assurance (QA) Reviewer. The job is the top operational authority in the risk adjustment coding group, offering expert answers to coding questions and shaping how coders carry out their work. The reviewer takes on the hardest coding, documentation and compliance cases, relying on Medicare risk adjustment rules, HCC methodology, ICD-10-CM guidance and documentation standards. Duties include examining…
Job Description
Vera Whole Health has an opening for a remote, full-time Risk Adjustment Quality Assurance (QA) Reviewer. The job is the top operational authority in the risk adjustment coding group, offering expert answers to coding questions and shaping how coders carry out their work.
The reviewer takes on the hardest coding, documentation and compliance cases, relying on Medicare risk adjustment rules, HCC methodology, ICD-10-CM guidance and documentation standards. Duties include examining medical records closely to confirm diagnoses and HCC capture, researching regulations to settle unusual problems, and owning core workflows. The reviewer also proposes changes that could improve quality, output and compliance.
No formal supervisory authority comes with the role, but the reviewer functions as an informal lead by coaching colleagues, training them, reviewing their coding and helping newer staff get settled. Other work includes writing coding reference guides, supporting audits and regulatory preparation, and joining projects linked to value-based care. The role works with little oversight, and its decisions affect departmental results and the integrity of documentation.
Responsibilities
- Serve as the main escalation contact for intricate coding, documentation and compliance questions
- Conduct detailed medical record reviews to verify diagnosis codes and HCC capture
- Resolve atypical coding problems through research and recommended outcomes
- Guide coders day to day through training, feedback and direction
- Review colleagues' coding output and offer coaching
- Help onboard and develop newer team members
- Manage assigned coding workflows and tools and propose enhancements
- Study coding and provider data to find documentation and capture gaps
- Prepare coding cheat sheets, reference documents and written procedures
- Assist with audits, quality checks and regulatory readiness
- Contribute to cross-team initiatives on coding accuracy and value-based care
Core Skills
Frequently Asked Questions
Answers are based only on the employer’s listing; where it doesn’t say, neither do we.
Is this QA Reviewer position remote?
Yes. The posting lists the role as remote and full-time.
What is the compensation range?
The posted pay band runs from $27.82 to $41.72. It notes that final pay depends on experience, skills, location and internal equity.
Does the posting list specific education or certification requirements?
No. The posting does not list specific education, certifications or years of experience.
Does this role manage staff directly?
No formal supervisory responsibility is stated. The posting describes an indirect team lead role that provides training, coaching and quality review.
Sample Interview Questions
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