Remote Risk Adjustment Coding Auditor

TEKsystems; United States; Remote; USD 44,000 - 51,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Job summary

TEKsystems is seeking an experienced Risk Adjustment Coding Auditor for contract work located in Minneapolis, MN. The role focuses on accurate risk adjustment coding across Medicare, Medicaid, and ACA populations, ensuring documentation aligns with CMS-HCC guidelines and regulatory requirements.

The ideal candidate has 7+ years in risk adjustment coding/auditing, CRC certification, and strong proficiency with Microsoft Office.

Qualifications

• 7+ years of related professional experience.
• 5+ years of HCC coding experience utilizing inpatient and outpatient coding guidelines.
• 5+ years of experience auditing risk adjustment records.
• 1+ year of experience working in a production-driven environment.

Responsibilities

• Conduct retrospective and prospective chart reviews to validate risk adjustment diagnoses and reporting accuracy.
• Audit provider-reported diagnosis codes for accuracy, specificity, completeness, and documentation support.
• Review medical records to identify complete and accurate diagnosis capture in alignment with CMS-HCC guidelines.
• Ensure coding practices comply with applicable regulatory requirements, coding standards, and organizational policies.
• Maintain compliance with HIPAA, privacy, security, and confidentiality requirements when handling patient information.
• Identify coding discrepancies, documentation gaps, and trends that may impact risk adjustment performance.
• Provide written and verbal feedback regarding coding errors, audit findings, and process improvement opportunities.
• Support organizational audit and production goals while meeting established deadlines and productivity standards.
• Assist with risk mitigation reviews, special projects, and supplemental audit initiatives.
• Serve as a subject matter expert on risk adjustment methodologies, diagnosis coding, and regulatory requirements.
• Collaborate with internal stakeholders to improve coding accuracy and documentation practices.

Skills

HCC coding

Risk adjustment auditing

Regulatory compliance

CMS guidelines knowledge

Communication skills

Education

CRC certification

Bachelor's degree (preferred)

Job description

TEKsystems is seeking an experienced Risk Adjustment Coding Auditor for contract work located in Minneapolis, MN. The role focuses on accurate risk adjustment coding across Medicare, Medicaid, and ACA populations, ensuring documentation aligns with CMS-HCC guidelines and regulatory requirements.

The ideal candidate has 7+ years in risk adjustment coding/auditing, CRC certification, and strong proficiency with Microsoft Office.