Senior Risk Adjustment Auditor II – Hybrid (Remote Options)

Cambia Health Solutions; Idaho; Hybrid; USD 58,000 - 89,000; Full time

Benefits offered by this job

Work from home options

Office flexibility

Job summary

Cambia Health Solutions is seeking a Risk Adjustment Auditor I or II for a hybrid role with three days in office across designated U.S. locations, including OR/UT/ID states.

The role focuses on retrospective and prospective chart reviews to ensure accurate risk adjustment reporting and coding integrity. You will analyze provider documentation, identify coding trends, and collaborate with the coding team and leadership to implement corrective actions.

Qualifications

• Associate degree in Healthcare or related field required or equivalent experience.
• Experience with Risk Adjustment, HCC or inpatient coding.
• Certification in CPC and CRC preferred or required.

Responsibilities

• Perform retrospective and prospective chart reviews to ensure accurate risk adjustment reporting.
• Verify accuracy and completeness of provider diagnosis codes based on medical records.
• Identify trends in provider and vendor coding and communicate findings to leadership.

Skills

Risk Adjustment

Auditing

Medical coding

Retrospective chart review

Prospective chart review

Analytical skills

Communication skills

MS Office

AI tools familiarity

Education

Associate degree in Healthcare or related field

Tools

Excel

Word

Outlook

Job description

Cambia Health Solutions is seeking a Risk Adjustment Auditor I or II for a hybrid role with three days in office across designated U.S. locations, including OR/UT/ID states.

The role focuses on retrospective and prospective chart reviews to ensure accurate risk adjustment reporting and coding integrity. You will analyze provider documentation, identify coding trends, and collaborate with the coding team and leadership to implement corrective actions.