Remote Risk Adjustment Coding Auditor (HCC Expert)

TEKsystems; Minneapolis (MN); Remote; USD 44,000 - 51,000; Full time

Benefits offered by this job

Medical insurance

Dental & vision

401(k) plan

HSA

Life Insurance

Disability

Paid time off

Job summary

TEKsystems is seeking an experienced Risk Adjustment Coding Auditor to ensure accurate Medicare/Medicaid/ACA coding. The role focuses on HCC coding, auditing, and regulatory compliance across populations, while guiding documentation best practices.

The ideal candidate will have senior-level experience, strong analytical skills, and the ability to educate others. This fully remote contract role supports audits and process improvements within a national scope.

Qualifications

• 7+ years of related professional experience.
• 5+ years of HCC coding experience using inpatient/outpatient guidelines.
• 5+ years auditing risk adjustment records.
• 1+ year in a production-driven environment.
• Intermediate knowledge of Medicare, Medicaid, ACA risk adjustment models.
• Ability to interpret/apply coding policies with critical thinking.
• Experience educating on coding errors and trends.
• Proficiency with MS Office Suite.

Responsibilities

• Conduct retrospective/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 align with CMS-HCC guidelines.
• Ensure coding practices comply with regulatory requirements and policies.
• Maintain HIPAA/privacy/confidentiality compliance when handling patient information.
• Identify coding discrepancies and trends affecting risk adjustment performance.
• Provide written/verbal feedback on errors and opportunities for process improvement.
• Support audits and production goals with deadlines and productivity targets.
• Assist with risk mitigation reviews and supplemental audit initiatives.
• Serve as SME on risk adjustment methodologies and regulatory requirements.
• Collaborate with internal stakeholders to improve coding accuracy and documentation.

Skills

Experience auditing risk adjustment

HCC coding knowledge

Regulatory compliance

Analytical skills

Documentation education

Office suite proficiency

Time management

Production environment

Education

Bachelor's degree

RHIT/RHIA credential

HEDIS/STARS experience

Provider education experience

RADV audit experience

CPMA or coding certs

NLP tooling experience

Advanced risk adjustment knowledge

Tools

Microsoft Excel

Microsoft Word

Microsoft Outlook

Microsoft PowerPoint

Job description

TEKsystems is seeking an experienced Risk Adjustment Coding Auditor to ensure accurate Medicare/Medicaid/ACA coding. The role focuses on HCC coding, auditing, and regulatory compliance across populations, while guiding documentation best practices.

The ideal candidate will have senior-level experience, strong analytical skills, and the ability to educate others. This fully remote contract role supports audits and process improvements within a national scope.