MRA Chart Reviewer

Job Title: MRA Chart Reviewer

Department: Revenue Cycle / Quality & Compliance
Location: Remote
Reports To: MRA Manager / Coding Manager

Job Summary

The MRA Chart Reviewer is responsible for reviewing medical records to identify, validate, and capture accurate diagnoses in support of Medicare Risk Adjustment (MRA) and HCC coding. This role ensures documentation supports all reported conditions and complies with CMS and ICD-10-CM guidelines.

Key Responsibilities

• Review patient medical charts for completeness, accuracy, and compliance with CMS Risk Adjustment guidelines
• Identify and validate HCC (Hierarchical Condition Category) diagnoses
• Ensure all chronic and acute conditions are properly documented and coded
• Perform retrospective and prospective chart reviews
• Collaborate with providers to clarify documentation when needed
• Identify documentation gaps and provide feedback to providers
• ...