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Medicare Risk Adjustment Audit Jobs in Iowa (NOW HIRING)

Join a growing team of Medicare specialists and healthcare professionals dedicated to delivering ... The level may impact the salary range and these adjustments would be clarified during the offer ...

Staff Accountant

Des Moines, IA · On-site

$53K - $70K/yr

... Medicare & Medicaid Services). We have 45+ years of experience assisting our government clients ... Conduct all phases of the audit including planning and research, risk assessment, fieldwork ...

Assurance Manager

Cedar Rapids, IA · On-site

$109K - $131K/yr

... risk assessment procedures, to perform appropriate audit procedures, to perform quality control ... adjustments, client obstacles, etc. * Identify technical issues involving changes in client ...

Assurance Manager

Cedar Rapids, IA · On-site

$109K - $131K/yr

... risk assessment procedures, to perform appropriate audit procedures, to perform quality control ... adjustments, client obstacles, etc. * Identify technical issues involving changes in client ...

Assurance Manager

Cedar Rapids, IA · On-site

$80 - $100/hr

... risk assessment procedures, to perform appropriate audit procedures, to perform quality control ... adjustments, client obstacles, etc. * Identify technical issues involving changes in client ...

Coding Auditor

Manchester, IA

$24.50 - $28/hr

... Medicare and Medicaid (CMS) guidelines. Provides ongoing feedback and analysis of the education ... Responds to identified areas of risk through investigation and internal audit to ensure compliance ...

Ensure risk-based controls and policies in force for Spain are followed and applied by the AFC ... Support the Head of AFC - Southern Europe in identifying any audit requirements and oversee any ...

Clinical Services Director

Nevada, IA · On-site

$110 - $140/hr

Design and implement workflows that support Medicaid, Medicare, and MCO billing compliance ... Serve as the agency's Clinical Lead in contract discussions, audits, and collaborations with ...

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Showing results 21-40

Medicare Risk Adjustment Audit information

What is a Medicare Risk Adjustment Audit?

A Medicare Risk Adjustment Audit is a review process conducted to ensure that healthcare providers are accurately reporting patient diagnoses to Medicare Advantage plans. This audit verifies that submitted diagnoses are supported by proper medical documentation, which affects how much Medicare pays to health plans. The goal is to prevent overpayments or underpayments and to ensure compliance with federal regulations. These audits are typically performed by the Centers for Medicare & Medicaid Services (CMS) or their contractors.

What are some common challenges faced by professionals in Medicare Risk Adjustment Audit roles, and how can they be addressed?

Professionals in Medicare Risk Adjustment Audit roles often encounter challenges such as interpreting complex medical documentation, staying updated on evolving CMS guidelines, and ensuring data accuracy for compliant risk scoring. Effective collaboration with coders, providers, and compliance teams is essential to resolve discrepancies and achieve audit objectives. Staying proactive in ongoing training and leveraging audit technologies can help address these challenges and contribute to high-quality, compliant results.

What are the key skills and qualifications needed to thrive as a Medicare Risk Adjustment Auditor, and why are they important?

To thrive as a Medicare Risk Adjustment Auditor, you need expertise in medical coding, healthcare compliance, and an understanding of CMS risk adjustment guidelines, often supported by a coding certification such as CPC or CRC. Familiarity with auditing software, electronic health records (EHRs), and data analytics tools is typically required. Attention to detail, analytical thinking, and strong communication are essential soft skills for reviewing documentation and conveying findings. These skills are crucial for ensuring accurate risk adjustment coding, regulatory compliance, and optimized reimbursement for healthcare organizations.

What is the difference between Medicare Risk Adjustment Audit vs Medicare Coding Specialist?

AspectMedicare Risk Adjustment AuditMedicare Coding Specialist
Primary FocusReviewing and verifying accuracy of risk adjustment dataAssigning correct medical codes for billing and documentation
CertificationsRisk adjustment or auditing certifications often preferredMedical coding certifications like CPC or CCS
Work EnvironmentHealthcare organizations, insurance companies, auditing firmsHospitals, clinics, billing companies
Industry UsageUsed in Medicare Advantage plan compliance and reimbursementUsed in medical billing and claims processing

While both roles involve healthcare data, Medicare Risk Adjustment Auditors focus on verifying the accuracy of risk scores for Medicare payments, whereas Medicare Coding Specialists assign medical codes for billing purposes. Understanding these differences helps in choosing the right career path or job focus within the healthcare industry.

What are popular job titles related to Medicare Risk Adjustment Audit jobs in Iowa?

For Medicare Risk Adjustment Audit jobs in Iowa, the most frequently searched job titles are:

What job categories do people searching Medicare Risk Adjustment Audit jobs in Iowa look for?

The top searched job categories for Medicare Risk Adjustment Audit jobs in Iowa are:

What cities in Iowa are hiring for Medicare Risk Adjustment Audit jobs?

Cities in Iowa with the most Medicare Risk Adjustment Audit job openings:

Infographic showing various Medicare Risk Adjustment Audit job openings in Iowa as of August 2026, with employment types broken down into 1% As Needed, 91% Full Time, 6% Part Time, and 2% Contract. Highlights an 82% Physical, 5% Hybrid, and 13% Remote job distribution.

Medical Coordinator I

Corvel

West Des Moines, IA

$14.68 - $22.69/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago


CorVel rating

7.9

Company rating: 7.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

86th of 151 rated financial services


Job description

Join a growing team of Medicare specialists and healthcare professionals dedicated to delivering high-quality Medicare compliance solutions. The Medical Coordinator plays a key role in supporting Medicare lien resolution, medical cost projections, and Medicare Set-Aside services. This position works closely with Certified Nurse Medicare Specialists and Nurse Life Care Planners to ensure accuracy, quality, and exceptional client service.

This is an excellent opportunity for an organized and detail-oriented professional with medical terminology knowledge who enjoys working in a collaborative, fast-paced environment where their contributions directly impact client outcomes.

Essential Functions & Responsibilities

  • Proofread, format, and quality-review medical reports, cost projections, and client correspondence for accuracy and consistency.
  • Assist in the preparation of Medicare-related documentation, including lien and medical cost projection support activities.
  • Verify the accuracy of ICD diagnosis codes and medication information
  • Provide customer support by communicating with Medicare Advantage Plans, subrogation offices, healthcare providers, and other stakeholders.
  • Review, extract, and organize medical records and supporting documentation.
  • Upload and manage documents within government portals and internal systems while maintaining confidentiality and compliance standards.
  • Track and prioritize multiple assignments to ensure timely completion of deliverables.
  • Support Certified Nurse Medicare Specialists, Nurse Life Care Planners, and the broader nursing team with administrative and project-related activities.
  • Perform other duties as assigned to support departmental and organizational goals.

Knowledge & Skills

  • Strong understanding of medical terminology and healthcare documentation.
  • Exceptional attention to detail and commitment to quality and accuracy.
  • Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
  • Excellent written, verbal, and interpersonal communication skills.
  • Proficiency with Microsoft Office applications, including Word, Excel, Outlook, and document management systems.
  • Strong analytical, organizational, and time management skills.
  • Ability to work independently while also contributing effectively within a collaborative team environment.
  • Demonstrated professionalism, adaptability, and customer service orientation.

Education & Experience

Required:

    • High school diploma or equivalent.

Preferred:

    • Experience working with medical terminology and healthcare records.
    • Clinical, medical office, healthcare administration, workers' compensation, case management, or insurance industry experience.
    • Experience reviewing medical records and healthcare documentation.
    • Associate's degree, medical assistant certification, or other healthcare-related education.

Why Join Us?

  • Work alongside experienced Medicare Specialists and Nurse Life Care Planners.
  • Gain specialized knowledge in Medicare compliance and medical cost projections.
  • Be part of a collaborative, mission-driven team focused on delivering exceptional service.
  • Opportunity for professional development and career growth within a respected industry leader.

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location.  Pay rates are established taking into account the following factors:  federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.  Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $14.68 - $22.69 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL:

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.   CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients.  We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.  Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). 

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. 

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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