Risk Adjustment Coding Auditor

TEKsystems; Chicago (IL); A distancia; USD 44.000 - 51.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

PTO

Descripción de la vacante

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.

Formación

• 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

Responsabilidades

• 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

Conocimientos

Audit

CRC

Coding

Risk Adjustment

Health Insurance

Educación

CRC (Certified Risk Coder)

Descripción del empleo

This position is 100% remote

Job Description

The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise.

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 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

Top Skills Details

Audit, CRC, Coding, Risk Adjustment, Health Insurance

Qualifications

• 5+ years of HCC coding experience in utilizing inpatient and outpatient coding guidelines
• 5+ years of experience auditing Risk Adjustment records
• 1+ years working in a Production environment
• CRC (Certified Risk Coder) in good standing
• Intermediate level of knowledge in risk adjustment Medicare, ACA Commercial and Medicaid models

Job Type & Location

This is a Contract position based out of Chicago, IL.

Pay And Benefits

The pay range for this position is $32.00 - $37.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors. 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 the following: 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)

Job Type & Location

This is a Contract position based out of Chicago, IL.

Application Deadline

This position is anticipated to close on Nov 14, 2026.

Workplace Type

This is a fully remote position.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems And TEKsystems Global Services

We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.