Member risk adjustment coordinator i

Are you a detail-oriented, empathetic professional looking for a rewarding work-from-home role supporting healthcare audit operations? We are seeking a dedicated Member Risk Adjustment Coordinator to join our collaborative team!

In this key remote position, you will support Risk Adjustment Data Validation (RADV) audits by retrieving medical records, managing escalations, and maintaining audit tracking metrics. Working standard daytime hours (Monday through Friday, 8:00 AM - 5:00 PM CST), you will conduct outbound calls to provider offices to request charts, schedule member office visits with primary care providers, and update member and provider demographics. You will also compile records from electronic systems, resolve vendor pends, and ensure follow-up on member appointments while maintaining audit-ready documentation in alignment with CMS and HHS standards. If you bring strong problem-solving capabilities, proficiency in Microsoft Excel, and exceptional cross-functional communication skills, this contract opportunity offers a supportive environment to apply your expertise.

salary: $22.99 - $23 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

Position Summary:

Retrieve charts from electronic medical record systems, conduct outbound calls to provider groups, assist members with primary care scheduling, and maintain accurate audit tracking for RADV projects.

Key Responsibilities:

• Retrieve charts from electronic medical record systems and compile records for coding review.
• Place outbound phone calls to provider offices and healthcare groups to request needed medical records.
• Assist members with scheduling primary care provider visits and follow up on appointment completion.
• Update member and provider demographic data in Excel and internal systems to resolve outstanding vendor pends.
• Maintain complete, accurate, and audit-ready tracking documentation in compliance with CMS and HHS guidelines.
• Collaborate cross-functionally with internal teams, vendors, and health plans to support high chart retrieval performance rates.

Requirements:

• High School Diploma or GED required.
• 0-2+ years of customer service or medical office experience.
• Basic to intermediate proficiency in Microsoft Excel and data tracking.
• Excellent attention to detail, problem-solving abilities, and cross-functional communication skills.
• Dedicated, private remote workspace located in Florida, Missouri (St. Louis area), or Tennessee.
• Preferred: Experience with medical record retrieval systems, healthcare billing, or coding concepts.

Skills

• Microsoft Office
• Multi-tasking
• Prioritizing

Qualifications

• Years of experience: 2 years
• Experience level: Experienced

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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on click.appcast.io.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

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.