Auditor, HCC Risk Adjustment Coding
$29 - $32 per hourDatavant
Job Description
Job Description
Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health.
By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare.What We're Looking For:
As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of a patient's health status and confirming the accuracy of said work.
What You Will Do:
- Audit coded charts assigned by quality supervisor per the client guidelines
- Ability to move from different sets of client guidelines with minimal difficulty
- Maintain a 95% quality average at a diagnosis level
- Answer rebuttals entered on the auditor by coders and or auditors
- Participate in weekly coding project review meetings
- Any other tasks asked by quality supervisor
What You Need to Succeed:
- 2 years' HCC Coding experience
- 2 years' HCC Auditing experience
- Extensive knowledge of ICD -10
- High school diploma or GED equivalent required
- AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC)
- A strong knowledge base of medical terminology, medical abbreviations, pharmacology, and disease processes
- Ability to work in a fast-paced production environment while maintaining high quality
- Must be able to follow instructions, meet deadlines and work independently
- Ability to be flexible in work environment
- Excellent written and verbal communication skills, ability to work in a remote environment and time management skills
- Working knowledge of the business use of computer hardware and software to ensure effectiveness and quality of the processing and security of the data
What We Offer:
- Comprehensive health, dental, and vision insurance
- Paid time off (PTO) plan
- Retirement savings plan
- Flexible work arrangements
- Opportunities for career growth and development
- Employee wellness programs
We are committed to building a diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.
At Datavant our total rewards strategy powers a high-growth, high-performance, health technology company that rewards our employees for transforming health care through creating industry-defining data logistics products and services. The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific job.The estimated total cash compensation range for this role is:
$29—$32 USD
To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.
This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here. Requests for reasonable accommodations will be reviewed on a case-by-case basis.For more information about how we collect and use your data, please review our Privacy Policy.
- Oscar Health is hiring an Associate, Risk Adjustment Auditor for their Risk Adjustment team. This remote role focuses on conducting quality audits related to ICD-10 code accuracy and completeness. You will engage in audit operations and compliance, while working with the...RiskRemote job
- Vytwo in Dallas, TX seeks a Risk Adjustment Coding Auditor for a 6-month engagement to support CMS RADV audit passes. The role requires a CPC and CRC certification and 5+ years of risk adjustment experience, with proficiency in MS Office. The team will run first and second...Risk
- Job Overview Role type: Risk Adjustment Coding Auditor. Quantity of resources: 2. Duration: 6 months. JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required Skills MS Suite CPC certified...Risk
$82.72k - $108.57k
...Job Description Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team. Oscar is the first health... ...quality audits. Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and identified...RiskFull timeWork experience placementRemote workWork from homeHome office- ...(“IES”) is seeking a Certified Medical Coding Auditor with emphasis on auditing surgical services... ...integrity, identifies coding compliance risks (including undercoding, overcoding, and... ..., depth perception, and the ability to adjust focus While performing the duties of...RiskFull timeWork at officeLocal areaRemote workFlexible hoursNight shift
- ...make a difference as a Senior Compliance Auditor. Being a part of something this great starts... ..., Clinical Managers and others regarding coding, documentation, OASIS guidelines, and... ...serious compliance, billing, or other business risks timely to the Director of Compliance...RiskLocal area
- Elara Caring is seeking a Senior Compliance Auditor to join our team, focusing on comprehensive audits across skilled home health, hospice... ...include an RN license with a BSN/ASN, 5+ years in healthcare coding/billing compliance, and 2+ years of leadership. Certifications...Risk
- Job Title: Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking... ..., evaluating, and refining medical coding and audit-related content. This opportunity... ...quality. Identify coding trends, gaps, risks, and opportunities for improvement. Evaluate...RiskRemote jobFor contractors
- ...seeking a Compliance Analyst III, Hospital Billing Auditor to join the Office of Institutional Compliance... ...services. You will lead audits, identify risks, and collaborate with Revenue Cycle, Patient Financial Services, Coding, Clinical Operations, and Compliance leaders to...RiskWork at office
- ...enhancing our organization's internal controls, risk management, and governance processes.... ...in internal auditing, medical billing/coding, or clinical experience in a healthcare setting... .../Licensure ~ Certified Internal Auditor (CIA), Certified Public Accountant (CPA),...RiskFull timeWork at officeMonday to Friday
$104.9k - $199.07k
...healthcare financing, enterprise risk management and regulatory... ...expansion revenue across our risk adjustment portfolio. This is a selling... ...evolving areas in healthcare, where coding accuracy, documentation... ...in the surrounding market (CMS-HCC models, RADV, quality programs...RiskFull timeWork experience placementRemote workFlexible hoursShift work- ...Compliance Analyst III, Hospital Billing Auditor (959433) Job Description Compliance Analyst... ...documentation to ensure accurate coding, charging, and reimbursement for inpatient... ...services. Identify billing trends, compliance risks, and opportunities for process...RiskFull timeWork at office
$101k - $155k
...Tanium's audit program, leading a team of auditors, developing audit methodology, and... ...are established for gaps identified during risk assessments, audits, and inspectionsAdvises... ...actual annual base salary offered may be adjusted based on a variety of factors, including...RiskFull timeLive inWorldwideFlexible hours$100k - $155k
...hands-on experience with FedRAMP compliance processes and federal risk management frameworks, including exposure to FedRAMP High and... ...will pay a new hire. The actual annual base salary offered may be adjusted based on a variety of factors, including but not limited to,...RiskFull timeLive inWorldwideFlexible hours- ...has an excellent opportunity for an Sr. Auditor located at our National Center office... ...effectiveness of our internal controls, risk management processes, and compliance... ...review the market value of jobs and make adjustments, as needed. Performance and Recognition...RiskFull timeWork at officeLocal area2 days per week3 days per week
$70k - $75k
...Financial Services & Insurance Attorney Auditor This is a fully remote position, and... ...roles. Sedgwick is the world’s leading risk and claims administration partner, which... ...solutions in claims administration, loss adjusting, benefits administration, and product recall...RiskLocal areaRemote workWork from homeFlexible hours$98.9k - $148k
...We’re seeking a Senior Health & Safety Auditor that will be responsible for planning and... ...supports continuous improvement initiatives, risk reduction, and operational excellence... ...require further support or reasonable adjustments with regards to the recruitment process...RiskFull timeWork at officeLocal areaRemote work- ...ExpertiseMust demonstrate a solid understanding of Coding Guidelines and CPT Guidelines for E/M (... ...used in the clinic setting is essential.Risk Adjustment Experience: While Risk Adjustment... ...in ICD-9/ICD-10-CM/PCS, CPT-4/HCPCS, HCC and HEDIS CAT II, E/M codingknowledge &...RiskContract workWork at office
- Mortgage Servicing QC Auditor Agility 360 is searching for a Mortgage Servicing QC Auditor... ...related experience in audit, compliance, risk management or quality control in loan servicing... ..., depth perception and the ability to adjust focus. Must be able to speak and hear,...RiskHourly payContract workLocal areaWork from home
$101.8k - $208.2k
...assist our clients with transforming their governance, embedding risk in their decision-making and maintaining efficient compliance.... ...organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location...RiskWork experience placementLocal areaWorldwide- ...Certified Risk Adjustment Medical Coder (CRC)Our client is seeking an experienced Certified Risk... ...with CMS documentation standards, ICD-10 coding guidelines, and regulatory requirements.... ...outpatient medical records to validate HCC diagnoses.Determine whether submitted diagnosis...RiskContract workRemote work
- ...EXPERIENCE: 5+ years of progressive experience in internal audit, external audit (Big 4/public accounting preferred), SOX compliance, risk management, or related assurance functions.CERTIFICATIONS / LICENSES: CPA, CIS, CISA or equivalent professional certification...RiskHourly payWork experience placement
- ...proprietary models - to ensure that every decision is strategic, focused, and produces exceptional multifamily communities with the best risk-adjusted returns. More than just great communities, JPI is focused on leaving a lasting impact on the communities where we build and is...RiskWork experience placementWork at officeFlexible hours
- ...performers as proven as our products. Join us. We are seeking a Senior Auditor to join our high-performing Internal Audit team, a strategic... ...processes to evaluate efficiency, effectiveness, and risk management.This position offers a unique opportunity to gain exposure...Risk
$92.82k - $109.2k
...DescriptionThe Corporate Audit Services (CAS) Senior Auditor role will work with limited oversight to... ...Senior Auditor is expected to understand risk and risk management techniques, identify... ...policies and procedures including the Code of Ethics and Business Conduct and related...RiskFull timeWork at officeLocal area3 days per week$92.82k - $109.2k
...-Time Payments, FedNow etc.The CAS Senior Auditor is primarily responsible for assisting in... ...Senior Auditor is expected to understand risk and risk management techniques, identify and... ...Bank policies and procedures including the Code of Ethics and Business Conduct and related...RiskWork at officeLocal area3 days per week- ...organizations. Altegra Health specializes in:CMS HCC Risk AdjustmentHEDISMedical Record Reviews (... ...apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes... ...Official Coding Guidelines and Risk Adjustment Guidelines).Responsibilities:Abstract...RiskTemporary workRemote workWork from home
- Hilltop Holdings is currently looking to hire a Senior IT Auditor. The Senior IT Auditor is responsible for planning, organizing, and executing... ...disciplined approach to evaluate and improve the organization’s risk management, internal control, and governance processes. As a...RiskCurrently hiringRelocation package
- ...clients build resilience from within. We blend risk strategy, digital identity, cyber defense... ...security posture improvement.Agentic coding is not a supporting skill for this role—... ...for client CISO and CTO: build risk-adjusted investment cases, security architecture roadmaps...RiskFull timeWork experience placementLive inWork at officeLocal area
$99k - $232k
...Manager, you will play a pivotal role in delivering end-to-end internal audit services to clients across various industries. Within our Risk Consulting practice, you will help build, optimize, and deliver internal audit services, leveraging AI and other risk technologies...RiskFull timeH1b
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Auditor, HCC Risk Adjustment Coding. Be the first to apply!



