Risk Adjustment Coding Auditor
$35 - $38 per hourTemporary
Dahl Consulting
Title : Risk Adjustment Coding Auditor
Location : Remote
Job Type : Contract (6 months)
Compensation : $35.00 – $38.00 per hour
Industry: Health Insurance --- About the Role
Our firm is partnering with a leading nonprofit health insurance organization that serves members across commercial, Medicare, and Medicaid health plans. We are seeking an experienced Risk Adjustment Coding Auditor to help ensure the accuracy, integrity, and compliance of clinical coding and documentation used in risk adjustment programs.
In this role, you will support accurate reimbursement and regulatory compliance by conducting detailed coding audits, identifying documentation gaps, and providing expert guidance on risk adjustment coding practices. This position is ideal for a coding professional with strong HCC auditing experience who is passionate about data accuracy, compliance, and continuous improvement. Job Description
As a Risk Adjustment Coding Auditor , you will evaluate coded clinical data to ensure compliance with risk adjustment regulations, coding guidelines, and industry best practices. You will work closely with internal stakeholders to improve coding accuracy, support audit initiatives, and mitigate financial and regulatory risk.
Key Responsibilities
Required Qualifications
Dahl Consulting is proud to offer a comprehensive benefits package to eligible employees that will allow you to choose the best coverage to meet your family’s needs. For details, please review the DAHL Benefits Summary: How to Apply
Take the first step on your new career path! To submit yourself for consideration for this role, simply click the apply button and complete our mobile-friendly online application. Once we’ve reviewed your application details, a recruiter will reach out to you with next steps! Equal Opportunity Statement
As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply. If this position sounds like the right opportunity for you, we encourage you to take the next step and connect with us. We look forward to meeting you!#BP.Indeed
#LI-KA1
#LI-Remote
Location : Remote
Job Type : Contract (6 months)
Compensation : $35.00 – $38.00 per hour
Industry: Health Insurance --- About the Role
Our firm is partnering with a leading nonprofit health insurance organization that serves members across commercial, Medicare, and Medicaid health plans. We are seeking an experienced Risk Adjustment Coding Auditor to help ensure the accuracy, integrity, and compliance of clinical coding and documentation used in risk adjustment programs.
In this role, you will support accurate reimbursement and regulatory compliance by conducting detailed coding audits, identifying documentation gaps, and providing expert guidance on risk adjustment coding practices. This position is ideal for a coding professional with strong HCC auditing experience who is passionate about data accuracy, compliance, and continuous improvement. Job Description
As a Risk Adjustment Coding Auditor , you will evaluate coded clinical data to ensure compliance with risk adjustment regulations, coding guidelines, and industry best practices. You will work closely with internal stakeholders to improve coding accuracy, support audit initiatives, and mitigate financial and regulatory risk.
Key Responsibilities
- Perform retrospective and prospective medical record reviews to validate risk adjustment coding accuracy.
- Audit provider-reported diagnosis codes for accuracy, completeness, specificity, and appropriate documentation support.
- Review medical records to identify opportunities for complete and accurate CMS-HCC diagnosis code capture.
- Evaluate risk adjustment coding practices for consistency and compliance with applicable coding standards.
- Ensure compliance with HIPAA, privacy, security, and regulatory requirements when handling patient information.
- Monitor and apply current risk adjustment regulations, coding guidelines, and industry requirements.
- Provide written and verbal feedback regarding coding errors, trends, and improvement opportunities.
- Serve as a subject matter expert on risk adjustment coding processes and diagnosis coding methodologies.
- Support audit production goals and meet established turnaround times and deliverables.
- Participate in special projects, including risk mitigation reviews and other compliance-related initiatives.
- Collaborate with business partners to improve coding quality and documentation practices.
Required Qualifications
- 7+ years of relevant professional experience, including applicable work experience, education, transferable skills, or military experience.
- 5+ years of HCC coding experience utilizing both inpatient and outpatient coding guidelines.
- 5+ years of experience auditing risk adjustment records.
- 1+ year of experience working in a production-driven environment.
- Certified Risk Coder (CRC) credential in good standing, or the ability to obtain certification within six months of hire/conversion in addition to any required coding certification.
- Working knowledge of Medicare, ACA Commercial, and Medicaid risk adjustment models.
- Demonstrated ability to interpret and apply coding policies using strong analytical and critical thinking skills.
- Experience providing written and verbal guidance related to coding errors, trends, and compliance findings.
- Intermediate or higher proficiency with Microsoft Office applications, including Word, Excel, PowerPoint, and Outlook.
- Strong organizational skills with the ability to manage multiple priorities in a deadline-driven environment.
- High school diploma or equivalent.
- Bachelor's degree in a related field.
- HEDIS and/or STARS program experience.
- Provider education or training experience.
- Risk Adjustment Data Validation (RADV) experience.
- Certified Professional Medical Auditor (CPMA) or additional coding certifications.
- Experience supporting large health plan, managed care, or payer organizations.
Dahl Consulting is proud to offer a comprehensive benefits package to eligible employees that will allow you to choose the best coverage to meet your family’s needs. For details, please review the DAHL Benefits Summary: How to Apply
Take the first step on your new career path! To submit yourself for consideration for this role, simply click the apply button and complete our mobile-friendly online application. Once we’ve reviewed your application details, a recruiter will reach out to you with next steps! Equal Opportunity Statement
As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply. If this position sounds like the right opportunity for you, we encourage you to take the next step and connect with us. We look forward to meeting you!#BP.Indeed
#LI-KA1
#LI-Remote
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Risk Adjustment Coding Auditor in Minnesota vacancy
$35 - $38 per hour
...Title : Risk Adjustment Coding Auditor Location : Remote Job Type : Contract (6 months) Compensation : $35.00 - $38.00/hr Industry: Health Insurance --- About the Role Our client, a leading nonprofit healthcare organization serving members across...RiskContract workWork at officeRemote work- Optum, a part of UnitedHealth Group, seeks an experienced coder auditor to conduct independent, risk-based coding compliance audits from a telecommute-friendly role across the U.S. You will review CPT/HCPCS/ICD-10, Medicare/Medicaid rules, and prepare findings and remediation...RiskRemote job
- UnitedHealth Group is seeking a senior coding compliance auditor to independently perform risk-based audits of providers and clinical practices, ensuring CPT/HCPCS/ICD-10 accuracy and CMS compliance. You will analyze investigations, identify risk areas, and prepare detailed...RiskRemote job
$90.5k - $155.2k
...quality service is the norm and every member feels valued. The Risk Adjustment Healthcare Analyst (P3) is a senior-level individual... ...into actionable insights that inform financial performance, coding accuracy, and regulatory compliance. Operating with minimal...RiskWork experience placementWork at office3 days per weekMedica Services Company LLC
Hopkins, MN23 days ago$78.4k - $107.8k
...part of our caring community The Nurse Auditor 2 performs clinical audit/validation... ...medical record documentation and diagnosis coding for services rendered is complete, compliant... ...coding. Identifies members with high risk CMS Hierarchical Condition Categories (HCC...RiskBi-weekly payFull timeTemporary workApprenticeshipRemote workWork from homeHome officeMonday to FridayHumana
Saint Paul, MN3 days ago- ...opportunities for you to join our amazing team of healthcare professionals, right in your neighborhood. The Manager, Risk Adjustment and Coding at Johns Hopkins Community Physicians is a dynamic leadership role responsible for strategic oversight of ambulatory risk...RiskRemote jobFull timeShift work
$102.4k - $138.3k
...make a difference join us. The Impact Youll Have Blue Cross and Blue Shield of Minnesota is hiring a Program Manager Risk Adjustment Coding and this position youll be responsible for the design implementation evaluation and ongoing management of the Risk Adjustment...RiskFull timeFor contractorsWork at officeRemote work2 days per week$25 - $26.7 per hour
...Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical...RiskRemote workFlexible hoursDatavant
Saint Paul, MN1 day ago$70k - $75k
...Financial Services & Insurance Attorney Auditor ** This is a fully remote position,... ...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 hoursSedgwick
Saint Paul, MN21 hours ago- ...Risk Adjustment Coding Analyst Senior HealthPartners is hiring a Risk Adjustment Coding Analyst Senior. This position is responsible for diagnosis coding review and vendor coding quality assurance; working to ensure that plan performance and plan revenue is based...RiskRemote job
$117.6k - $206k
...for each use case, including workflow, low-code, RPA, API integration, orchestration, AI-... ...-ready, and sustainable.Support technical risk management, complex issue resolution, vendor... ...approach. Geographic factors may adjust the range estimate and hires typically fall...RiskFull timeVizient
Minneapolis, MN21 hours ago- Medica is seeking a senior Risk Adjustment Healthcare Analyst (P3) to deliver complex analytics and reporting that support the organization... ...data into insights that inform financial performance, coding accuracy, and regulatory compliance. Operating with minimal supervision...Risk
- Medica is seeking a senior Risk Adjustment Healthcare Analyst (P3) in Minnesota to translate claims data into actionable insights and support financial performance and regulatory compliance. You will own analytics, collaborate with actuarial, finance, clinical, and operations...RiskWork at office3 days per week
$70k - $75k
...Financial Services & Insurance Attorney Auditor PRIMARY PURPOSE : The Attorney... ...applying defined audit rules; documents adjustments and rationale clearly. Utilizes Sedgwick... ...Escalates complex, ambiguous, or high-risk billing issues to senior team members or...RiskFull timeWork at officeLocal areaFlexible hours$35 per hour
...Job Title: Risk Adjustment Coding Oversight Specialist (Risk Analyst)Job Description This role focuses on retrospective chart review and coding oversight for highly regulated Medicare Advantage risk adjustment programs. You will lead quality assurance and vendor oversight...RiskContract workTemporary workRemote workShift workEarly shiftTalentify.io
Minneapolis, MN4 days ago$91.7k - $163.7k
...as you take on some tough challenges.Primary Responsibilities:The key responsibilities of the role are as follows:Plan and execute risk-based assessments of control design and operating effectiveness across critical security domains (e.g., identity, access, network, cloud...RiskMinimum wageFull timeWork experience placementLocal areaRemote workShift workUnitedHealth Group
Eden Prairie, MN2 days ago$86.36k - $101.6k
...DescriptionThe Corporate Audit Services Senior Auditor is primarily responsible for completing... ...Senior Auditor is expected to understand risk and risk management techniques, identify... ...Bank policies and procedures including the Code of Ethics and Business Conduct and related...RiskWork at officeLocal area3 days per weekUS Bank
Minneapolis, MN1 day ago- ...Auditor Unique opportunity to join our Corporate Internal Audit & Advisory Services organization. The departments' activities and services... ...and improvement of processes that identify and manage risks related to achieving our business objectives. Key responsibilities...Risk
Direct Staffing Inc
Detroit Lakes, MN3 days ago - DataScan, part of Solifi, is seeking a Field Risk Specialist to perform on-site floorplan inventory audits at automotive, equipment, and powersports dealers across the territory. This field-based role requires travel, keen attention to detail, and the ability to verify...Risk
- ...to join our team as a Healthcare System Revenue Cycle Compliance Auditor. This role is responsible for planning and conducting audits of... ...analysis skills, and the ability to identify and mitigate compliance risks. They will collaborate closely with business leaders and...RiskLocal areaRemote work
UnitedHealth Group
Eden Prairie, MN21 hours ago - ...technical underwriting, intelligent operational efficiencies, sound risk management, dynamic claims team, and intensive specialization to... ...the carrier appropriately prices risk. The Role The Auditor should be prepared to review documents submitted for a potential...RiskWork at officeRemote work
Ategrity Specialty Insurance Company
Minneapolis, MN1 day ago $169.4k - $279.6k
...AI design • Help establish governance, risk, and control processes that ensure safe,... ...supporting transformational change. Able to adjust plans, priorities and strategies in... ...systems Hands-on experience with agentic coding tools such as Claude Enterprise/CLI/Code,...RiskTemporary workWork experience placementLocal areaTravelers Insurance
Saint Paul, MN3 days ago- ...with the client’s Global Health & Safety team to assess and continuously improve safety standards, processes, and practices to reduce risk. The ideal candidate brings strong relationship management, service delivery expertise, customer focus, and technical proficiency....RiskWork at officeLocal areaRemote work
Liberty Mutual
Minneapolis, MN2 days ago $100k - $125k
...Job Type Full-time Description The Senior Internal Auditor will support the Company's internal audit function and SOX 404... ...issue tracking. This position also offers exposure to enterprise risk management (ERM) and enterprise-wide process transformation...RiskFull timeMGM Transformers
Osseo, MN2 days ago$29 - $52 per hour
...organizations reduce costs while improving risk management,qualityand revenue growth.... ...Caring. Connecting. Growing together. The Coding Support Subject Matter Expert (SME) serves... ...with X EHR and Y coding tools/systems (adjust based on client) Knowledge of Medicare and...RiskHourly payMinimum wageFull timeWork experience placementLocal areaRemote work$78.68k - $157.88k
...Audit and Assurance Information Technology Auditor - Senior Consultant Do you thrive in... ...organizations effectively navigate business risks and opportunities—from strategic, reputation... ...| Deloitte US Careers Requisition code: 364912 Job ID 364912 Cyber and...RiskWork experience placementWork at officeLocal areaVisa sponsorshipDeloitte
Minneapolis, MN1 day ago$24 - $43 per hour
...Medical Coding AuditorOptum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...start Caring. Connecting. Growing together.The Medical Coding Auditor is required to determine the accuracy of claims submitted by a...Hourly payMinimum wageFull timeContract workWork experience placementLocal areaRemote workUnitedHealth Group
Minneapolis, MN3 days ago$59.3k - $80.9k
...Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and...Bi-weekly payFull timeContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to FridayHumana
Saint Paul, MN2 days ago- ...Problem solving skills (pragmatic and methodical) Other duties as assigned. Performs final inspection on product identified as High Risk Assists with Inventory Verifications, as needed Attend meetings as required. Qualities for Success: Demonstrates...Risk
Commercial Plastics LLC
Mora, MN2 days ago - DataScan by Solifi is seeking a Field Risk Specialist in Minnesota to perform floorplan inventory audits at automotive and equipment dealerships in Sauk Rapids and St. Cloud. You will verify VINs, review dealer records, and document findings in our mobile audit app while...RiskNight shift
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Risk Adjustment Coding Auditor. Be the first to apply!
