Certified Risk Adjustment Auditor

Job Summary

Ensuring the accuracy and compliance of coded clinical data, the full-time Risk Adjustment Coding Auditor will conduct chart audits, validate diagnosis codes, and support regulatory compliance in a fully remote contract position with potential for permanent conversion.

Key responsibilities

• Review and validate diagnosis codes for accuracy and compliance with CMS HCC and industry standards
• Conduct comprehensive chart audits to ensure accurate risk adjustment reporting
• Provide feedback on coding errors and support audit production goals based on business priorities

Required qualifications

• 7+ years of relevant professional experience
• 5+ years of HCC coding experience using inpatient and outpatient guidelines
• 5+ years auditing risk adjustment records
• CRC certification
• Intermediate knowledge of Medicare, ACA Commercial, and Medicaid risk adjustment models