Risk Adjustment Coding Auditor
Your 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
Qualifications
- 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
This is a Contract position based out of Eagan, MN.
Pay
The pay range for this position is $32.00 - $37.00/hr.
Benefits
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include: 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).
This is a fully remote position.
This position is anticipated to close on Aug 13, 2026.