Remote Risk Adjustment Coding Auditor

TEKsystems • Saint Paul, MN

1d • $32 - $37 • Remote

About The Position

We are seeking experienced Risk Adjustment Coding Auditors to support a growing healthcare organization during a high-volume operational period. This role is ideal for professionals with deep expertise in HCC coding, risk adjustment auditing, and regulatory compliance who thrive in a production-driven environment. This position offers the opportunity to work remotely while contributing to the accuracy, integrity, and compliance of risk adjustment programs that support quality healthcare outcomes and reimbursement processes.

Requirements

• 7+ years of relevant professional experience
• 5+ years of HCC coding experience utilizing inpatient and outpatient coding guidelines
• 5+ years of Risk Adjustment audit experience
• 1+ year working in a production-based environment
• CRC (Certified Risk Adjustment Coder) certification in good standing
• Working knowledge of Medicare, ACA Commercial, and Medicaid risk adjustment models
• Experience communicating coding findings and audit outcomes to stakeholders
• Intermediate proficiency with Microsoft Office (Excel, Word, Outlook, PowerPoint)
• Strong analytical, organizational, and critical thinking skills
• High School Diploma or equivalent
• Authorized to work in the United States without sponsorship

Nice To Haves

• Bachelor's Degree
• RHIT or RHIA certification with strong risk adjustment coding experience
• HEDIS and/or STARS experience
• Provider education experience
• RADV audit experience
• CPMA or additional coding certifications
• Experience with NLP software platforms

Responsibilities

• Audit risk adjustment codes for accuracy, consistency, and compliance with coding guidelines and best practices
• Perform retrospective and prospective medical record reviews
• Validate diagnosis coding based on provider documentation and CMS-HCC requirements
• Identify coding and documentation gaps that impact risk adjustment reporting
• Ensure compliance with HIPAA, privacy, security, and regulatory requirements
• Provide written and verbal feedback regarding coding errors, trends, and improvement opportunities
• Support audit initiatives, production goals, and special projects
• Act as a subject matter expert on risk adjustment coding and audit practices
• Complete audit deliverables within established timelines and quality standards

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

What This Job Offers

• Career Level: Mid Level
• Education Level: High school or GED