Risk Adjustment Coding Auditor

TEKsystems • Mendota Heights, MN

1d • $32 - $37 • Remote

About The Position

The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise.

Requirements

• CRC certified and in good standing
• 3+ years of experience auditing Risk Adjustment records
• Intermediate level of knowledge in risk adjustment Medicare, ACA Commercial and Medicaid models

Responsibilities

• Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices
• Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements
• Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting
• Verifies and ensures the accuracy, completeness, specificity and appropriateness of provider‑reported diagnosis codes based on medical record documentation
• Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories
• Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with requirements
• Contributes to audit and production efforts to meet business demand and workload priorities
• Provide written and verbal guidance on coding errors to others
• Meets audit deliverables within established timelines and deadlines
• Assists with special projects such as risk mitigation reviews
• Serves as subject matter resource regarding the risk adjustment process and diagnosis coding for risk adjustment

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: No Education Listed