Remote Risk Adjustment Auditor & Coding Specialist

TEKsystems; Chicago (IL); Remote; USD 44,000 - 51,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

PTO

Job summary

TEKsystems is seeking a Risk Adjustment Coding Auditor to ensure accuracy and integrity of coded clinical data across risk adjustment programs. The role focuses on identifying gaps, mitigating regulatory risk, and supporting compliant reporting.

Primarily remote with contract flexibility. The candidate will review CMS HCC categories, perform chart reviews, and ensure HIPAA and privacy compliance while aligning with coding standards.

Qualifications

• 5+ years of HCC coding experience in inpatient and outpatient settings
• 5+ years of auditing Risk Adjustment records
• 1+ years working in a Production environment
• CRC (Certified Risk Coder) in good standing
• Intermediate knowledge of CMS HCC 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 providerreported 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

Skills

Audit

CRC

Coding

Risk Adjustment

Health Insurance

Education

CRC (Certified Risk Coder)

Job description

TEKsystems is seeking a Risk Adjustment Coding Auditor to ensure accuracy and integrity of coded clinical data across risk adjustment programs. The role focuses on identifying gaps, mitigating regulatory risk, and supporting compliant reporting.

Primarily remote with contract flexibility. The candidate will review CMS HCC categories, perform chart reviews, and ensure HIPAA and privacy compliance while aligning with coding standards.