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Medicare Risk Adjustment Audit Jobs in Iowa (NOW HIRING)

Amazon

Site EHS Manager II

Bondurant, IA · On-site

You'll conduct comprehensive risk assessments, analyze safety data, and implement practical ... You'll lead safety compliance efforts, conduct thorough site audits, and analyze incident trends to ...

Nestle

Maintenance Planning Supervisor

Waverly, IA · On-site

... status quo, embrace risk-taking, and pioneer new ideas. Our supportive and collaborative ... Monitor/Audit technician data entry and quality into SAP/AMM system * Provide support and training ...

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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:

Medicare Risk Adjustment Audit jobs near you
Infographic showing various Medicare Risk Adjustment Audit job openings in Iowa as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 85% Physical, 5% Hybrid, and 10% Remote job distribution.

Registered Dietitian - Part Time (75% remote)

RD Nutrition Consultants

Keokuk, IA • On-site

$30 - $38/hr

Part-time

Posted 21 days ago

Job description

Clinical Registered Dietitian Position - Part-Time/Hybrid (75% remote) Company: RD Nutrition Consultants LLC Overview: RD Nutrition Consultants LLC is excited to offer an opportunity for a Clinical Registered Dietitian to join our team. This role offers flexibility and a balanced blend of in-person and remote work, allowing our patients to receive high-quality care while supporting a healthy work-life balance for our team. Facility Type: Skilled Nursing Schedule: 8-12 hours per week Flexibility: Choose your days and hours.

Only 1 onsite visit is required per month, with the remaining hours completed remotely via telehealth. Compensation: $30.00-$38.00 per hour, based on experience Travel Reimbursement: Paid at the same hourly rate for time spent traveling to and from the facility. Key Responsibilities: Conduct comprehensive nutritional assessments on new admissions and quarterly thereafter, with more frequent reviews as needed for high-risk residents

Develop, implement, and monitor individualized nutrition care plans. Provide nutrition education and counseling as needed. Collaborate effectively with physicians, nurses, therapists, and other members of the interdisciplinary care team.

Ensure compliance with all applicable state and federal regulations, including those related to the Centers for Medicare & Medicaid Services (CMS) and the Department of Health (DOH). Maintain appropriate documentation. Monitor residents for changes in weight weekly and/or monthly to identify potential changes in nutrition or hydration status.

Participate in quality improvement initiatives to enhance nutrition care services and resident outcomes as needed. Conduct monthly kitchen sanitation audits, documenting findings and recommending corrective actions to maintain a safe and sanitary environment. Review and approve menus on a semi-annual basis to ensure they meet applicable nutritional guidelines.

Perform other tasks as assigned and within scope of practice as needed. Experience & Qualifications: Bachelor's or Master's degree in Dietetics, Nutrition, or a related field from an accredited program. Registered by the Commission on Dietetic Registration.

Current state licensure/certification, if mandated by the state. Minimum of 1 year of clinical experience preferred. Excellent communication skills for effective interaction with patients, families, and healthcare teams.

Ability to apply critical thinking to a variety of situations, assess objectives, and develop, implement, and monitor effective plans for improvement. Proficiency in providing general nutrition interventions. Familiarity with state survey processes and nutrition care regulations.

Competency in electronic charting systems. RD Nutrition Consultants LLC is a leading Registered Dietitian Nutritionist consulting firm that provides dietitians to healthcare facilities across the United States. We offer competitive wages, flexible work schedules, and a supportive work environment.

To Apply: If you meet these qualifications and are interested in this opportunity, please submit your resume. RD Nutrition Consultants LLC is an Equal Opportunity Employer. Requirements.

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