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Remote Medicare Risk Adjustment Auditor Jobs (NOW HIRING)

Centene

Risk Adjustment Auditor Educator

$56K - $101K/yr

... Medicare risk adjustment (HCC Coding) Required Other experience in teaching, training or an ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Cambia Health Solutions

QA Risk ADj Auditor II

Boise, ID · On-site +1

... remote environment. Travel may be required, locally or out of state. May be required to work overtime. May be required to work outside normal hours. Risk Adjustment Auditor I: * Oregon, Utah, and ...

Cambia Health Solutions

QA Risk ADj Auditor II

Fargo, ND · On-site +1

... remote environment. Travel may be required, locally or out of state. May be required to work overtime. May be required to work outside normal hours. Risk Adjustment Auditor I: * Oregon, Utah, and ...

Insight Global

HCC Risk Adjustment Coder

Fort Worth, TX · Remote

$18 - $22/hr

Remote Contract Length: 5 Months Shift: Start time is flexible, need to log 40 hours. M-F Pay: $18 ... Perform accurate HCC risk adjustment coding for Medicare populations * Review and code medical ...

Greater Good Health

Risk Adjustment Coding Specialist

$80K - $95K/yr

Remote Company Description Greater Good Health is a fast-growing organization delivering care to ... The ideal candidate brings deep expertise in Medicare risk adjustment, a strong understanding of ...

Zing Health

Senior Risk Adjustment Coding Auditor

IL · Remote

$85K - $90K/yr

Description COMPANY OVERVIEW Zing Health is a tech-enabled insurance company making Medicare ... SUMMARY DESCRIPTION The Senior Risk Adjustment Coding Auditor is a highly experienced coding ...

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Remote Medicare Risk Adjustment Auditor information

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How much do remote medicare risk adjustment auditor jobs pay per hour?

As of Sep 10, 2026, the average hourly pay for remote medicare risk adjustment auditor in the United States is $19.21, according to ZipRecruiter salary data. Most workers in this role earn between $14.42 and $19.23 per hour, depending on experience, location, and employer.

What is a remote Medicare risk adjustment auditor?

A Remote Medicare Risk Adjustment Auditor is a professional who reviews medical records and other documentation to ensure accurate coding and reporting of diagnoses for Medicare Advantage plans. Their primary role is to verify that healthcare providers have properly documented patient conditions that affect risk adjustment payments from Medicare. By working remotely, these auditors use secure digital systems to access records and ensure compliance with CMS guidelines, helping healthcare organizations maximize appropriate reimbursement and minimize compliance risks.

What skills and qualifications are needed to be a remote Medicare risk adjustment auditor?

To thrive as a Remote Medicare Risk Adjustment Auditor, you need a strong background in medical coding, healthcare regulations, and risk adjustment methodologies, typically supported by a coding certification such as CPC, CRC, or CCS-P. Familiarity with coding software, electronic health record (EHR) systems, and audit tools is essential for accurate data review and reporting. Attention to detail, critical thinking, and strong written communication are important soft skills for this role. These skills ensure accurate risk assessment, compliance with Medicare guidelines, and maximized reimbursement for healthcare organizations.

What are the most common challenges faced by remote Medicare risk adjustment auditors, and how can they be overcome?

Remote Medicare Risk Adjustment Auditors often face challenges such as staying updated on changing CMS guidelines, accurately interpreting complex medical records, and maintaining productivity while working independently. To overcome these, auditors should regularly participate in professional development and training, utilize reliable audit tools and resources, and establish strong communication with their team and supervisors. Building a structured daily routine and fostering connections with peers through virtual meetings can also help maintain focus and support high-quality work.

What are popular job titles related to Remote Medicare Risk Adjustment Auditor jobs?

For Remote Medicare Risk Adjustment Auditor jobs, the most frequently searched job titles are:

Infographic showing various Remote Medicare Risk Adjustment Auditor job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 89% Full Time, 8% Part Time, and 2% Contract. Highlights an 85% Physical, 5% Hybrid, and 10% Remote job distribution, with an average salary of $39,947 per year, or $19.2 per hour.

Risk Adjustment Auditor Educator

Remote

Centene
Health Care and Social Assistance • 10K+ employees
Learn more about Centeneexternal

$56K - $101K/yr

Full-time

Medical, Retirement, PTO

Posted 22 days ago

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 406 frontline employees who took The Breakroom Quiz

12th of 898 rated healthcare providers

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Conduct provider medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of care. Analysis of MRA data to identify patterns and development of interventions at the provider and market level.

  • Subject matter experts for proper risk adjustment coding and CMS data validation
  • Work in conjunction with other departments to include Provider Relations, Quality as well as the Medical Director for the state assigned to ensure compliance of CMS risk adjustments guidelines are met.
  • Analyze MRA data to identify patterns and development of interventions at the provider and market level to coordinate an educational work plan for WellCare contracted providers.
  • Conduct provider education and training regarding risk adjustment to help to ensure accurate CMS payment and to improve quality of care.
  • This includes training venues such as provider offices, hospitals, webinars, conference calls, email correspondence, etc.
  • Works on additional risk adjustment audit requests (i.e. outside auditors' requests).
  • Serves on the RADV Committee as subject matter experts.
  • Perform quality assurance auditing (i.e. ensure appropriateness and accuracy of ICD-9/ICD-10 coding) for WellCare's Medical Coding Specialists.
  • Communicates QA results to the Medical Coding Specialists with suggestions for improvement and re-training topics.
  • Perform other duties as necessary.
  • Complies with all policies and standards

Education/Experience: Bachelor's degree or equivalent experience required

Candidate Experience: 5+ years of experience in a hospital, a physician setting or a Managed Care Organization as a medical coder
2+ years of experience in coding with knowledge of Medicare risk adjustment (HCC Coding)
Required Other experience in teaching, training or an educator/instructor role required; but provider education experience is preferred
Preferred Other managed care experience
Licenses and Certifications: A license in one of the following is required:
One of the following licensures required at hire: CPC or CCS
CRC required within the 1st year of employment
CPMA preferred on the 2nd year of employment

Pay Range: $56,200.00 - $101,000.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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