Risk Adjustment Coding Auditor

Description

Risk Adjustment Coding Auditor

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 provider‑reported 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

Provide written and verbal guidance on coding errors to others

Meets audit deliverables within established timelines and deadlines

Assists with special projects such as risk mitigation reviews

Serves as subject matter resource regarding the risk adjustment process and diagnosis coding for risk adjustment

Skills

Audit, CRC, Coding, Risk Adjustment, Health Insurance

Top Skills Details

Audit,CRC,Coding,Risk Adjustment,Health Insurance

Additional Skills & Qualifications

Required skills and experiences

7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.

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

Demonstrated ability to apply critical thinking skills to coding policy interpretation and implementation.

Experience providing written and verbal guidance on coding errors and trends

Intermediate (or higher) MS Office (Word, Excel, Powerpoint & Outlook)

Excellent organizational ability to manage multiple projects and perform in a deadline driven environment

High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred skills and experiences

Bachelor’s degree

HEDIS/STARS experience

Provider education experience

Prior RADV experience

CPMA or other coding credentials

NLP Software experience

Could possibly look at someone with RHIT or RHIA paired with the right coding expeirence.

Experience Level

Intermediate Level

This is a Contract position based out of Dallas, TX.

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)

This is a fully remote position.

This position is anticipated to close on Oct 1, 2026.

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.