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Entry Level Risk Adjustment Auditor Jobs (NOW HIRING)

CommunityCare, Inc.

The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10 ...

e4health

Risk Adjustment (RA)/HCC Coder/Auditor

$28 - $31.75/hr

The HCC Auditor is responsible for completing quality assurance reviews on internal or external coders/providers/accounts following the official ICD-10-CM and appropriate Risk Adjustment guidelines.

Datavant

Auditor, HCC Risk Adjustment Coding

$28 - $31.75/hr

... 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 ...

DaMar Staffing

Risk Adjustment Coder

Virginia Beach, VA · On-site

$10K/mo

Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits ... Conducts annual risk assessments, training, monitoring, & auditing, control assessment, reporting ...

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Entry Level Risk Adjustment Auditor information

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$30.5K

$72.6K

$117.5K

How much do entry level risk adjustment auditor jobs pay per year?

As of Sep 14, 2026, the average yearly pay for entry level risk adjustment auditor in the United States is $72,633.00, according to ZipRecruiter salary data. Most workers in this role earn between $47,000.00 and $98,500.00 per year, depending on experience, location, and employer.

What is the difference between Entry Level Risk Adjustment Auditor vs Risk Adjustment Analyst?

AspectEntry Level Risk Adjustment AuditorRisk Adjustment Analyst
CertificationsTypically requires certifications like CPC, CCS, or RHITOften requires similar certifications, with some roles preferring advanced credentials
Work EnvironmentPerforms audits in healthcare settings, insurance companies, or remoteAnalyzes data and reports in healthcare or insurance offices
Employer & Industry UsageCommon in health insurance companies, healthcare providers, and consulting firmsFound in insurance companies, healthcare organizations, and analytics firms

Both roles involve working with healthcare data and require similar certifications. The main difference is that Entry Level Risk Adjustment Auditors focus on reviewing and auditing medical records for compliance, while Risk Adjustment Analysts analyze data trends to improve risk models. The roles often overlap in industry and work environment, but auditors are more compliance-focused, whereas analysts emphasize data analysis and reporting.

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Entry Level Risk Adjustment Auditor jobs near you
Infographic showing various Entry Level Risk Adjustment Auditor job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 89% Full Time, 8% Part Time, and 2% Contract. Highlights an 82% Physical, 4% Hybrid, and 14% Remote job distribution, with an average salary of $72,633 per year, or $34.9 per hour.

Risk Adjustment - Risk Adjustment Auditor 135-2032

Tulsa, OK • On-site

CommunityCare, Inc.
See more jobs at CommunityCare, Inc.external

Other

Posted 4 days ago

Job description

Tulsa, OK, USA

Job Description

Posted Tuesday, September 8, 2026 at 6:00 AM

JOB SUMMARY:
The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity.

KEY RESPONSIBILITIES
  • Perform bi-directional retrospective and prospective medical record reviews to validate, clarify, and accurately capture risk adjusted diagnoses (HCCs) in accordance with CMS guidelines and MEAT documentation requirements.
  • Ensure documentation supports coded conditions in accordance with ICD-10-CM, CMS, and payer-specific guidelines.
  • Identify unsupported diagnoses, over coding, under-coding, and documentation gaps.
  • Provide detailed audit findings and recommendations to coding teams, providers, and leadership.
  • Monitor compliance with CMS Risk Adjustment Data Validation (RADV) standards.
  • Track and report audit results, trends, and performance metrics.
  • Collaborate with coding staff, providers, and operations teams to improve documentation quality and coding accuracy.
  • Assist with education and training initiatives related to risk adjustment and documentation best practices.
  • Maintain confidentiality and ensure compliance with HIPAA regulations.
  • Meet daily and weekly productivity goals and quality standards set by the supervisor.
  • Perform other job-related duties as required or assigned.
QUALIFICATIONS
  • Knowledge of CMS-HCC and HHS-HCC risk adjustment model.
  • Knowledge of ICD-10-CM coding guidelines.
  • Knowledge of RADV requirements.
  • Proficiency in EMR systems and Microsoft Office (Excel preferred).
  • High attention to detail.
  • Strong analytical and critical thinking skills.
  • Clear written and verbal communication.
  • Ability to work independently and meet deadlines.
  • Strong organizational skills.
  • Integrity and commitment to compliance.
  • Successful completion of Health Care Sanctions background check.
EDUCATION/EXPERIENCE
  • A minimum of two years of risk adjustment coding or auditing experience.
  • Experience reviewing medical records across multiple specialties.
  • Certified Professional Coder (CPC), CRC, CCS, or equivalent coding certification.
  • Bachelor’s degree in Health Information Management or related field preferred.
  • Previous auditing experience in Medicare Advantage and ACA preferred.
  • Experience with internal audit programs or payer audits preferred.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin

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