Risk Adjustment Coding Auditor

Job not on LinkedIn

🔥 0 minutes ago

❄️ Minnesota – Remote

❄️ Minnesota – Remote

💵 $32 - $37 / hour

⏳ Contract/Temporary

🟠 Senior

🔴 Lead

🔎 Auditor

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TEKsystems

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1983

💼 Consulting

🎯 Recruiter

🏢 Enterprise

Consulting • Recruitment • Enterprise

TEKsystems is a global IT and business services firm that provides technology consulting, talent solutions, managed services and workforce recruitment to enterprise clients. The company delivers cloud, digital and data services (including AI/ML and automation), application innovation, Agile/DevOps transformation, technology operations and digital experience work, and operates large-scale talent and managed service programs. TEKsystems works across industries (financial services, healthcare, public sector, telecommunications, retail/manufacturing, energy and more), maintains technology partnerships with major cloud and software providers, and reports more than $7B in annual revenue and 100+ locations worldwide.

📋 Description

• Audit risk adjustment codes for accuracy, consistency, and compliance with coding guidelines and best practices • Perform retrospective and prospective medical record reviews • Validate diagnosis coding based on provider documentation and CMS-HCC requirements • Identify coding and documentation gaps that impact risk adjustment reporting • Ensure compliance with HIPAA, privacy, security, and regulatory requirements • Provide written and verbal feedback regarding coding errors, trends, and improvement opportunities • Support audit initiatives, production goals, and special projects • Act as a subject matter expert on risk adjustment coding and audit practices • Complete audit deliverables within established timelines and quality standards

🎯 Requirements

• 7+ years of relevant professional experience • 5+ years of HCC coding experience utilizing inpatient and outpatient coding guidelines • 5+ years of Risk Adjustment audit experience • 1+ year working in a production-based environment • CRC (Certified Risk Adjustment Coder) certification in good standing • Working knowledge of Medicare, ACA Commercial, and Medicaid risk adjustment models • Experience communicating coding findings and audit outcomes to stakeholders • Intermediate proficiency with Microsoft Office (Excel, Word, Outlook, PowerPoint) • Strong analytical, organizational, and critical thinking skills • High School Diploma or equivalent • Authorized to work in the United States without sponsorship.

🏖️ Benefits

• 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)