2

Remote Risk Adjustment Auditor Jobs in Florida (NOW HIRING)

Lead Auditor, Medicare

Miami Beach, FL ยท On-site +1

$49K - $60K/yr

... risk management activities and special projects. Description This a part time position working ... This is a remote position and the task can be performed at any location. What You'll Do:

EHS Auditor / Consultant

Miami, FL ยท Remote

$98K - $135K/yr

South/Southeast USA - remote with up to 50% travel to client site Contract: Full-time, permanent ... S., including regulatory compliance and risk-based audits * Perform hands-on environmental ...

EHS Auditor / Consultant

Orlando, FL ยท Remote

$98K - $135K/yr

South/Southeast USA - remote with up to 50% travel to client site Contract: Full-time, permanent ... S., including regulatory compliance and risk-based audits * Perform hands-on environmental ...

EHS Auditor / Consultant

Tampa, FL ยท Remote

$98K - $135K/yr

South/Southeast USA - remote with up to 50% travel to client site Contract: Full-time, permanent ... S., including regulatory compliance and risk-based audits * Perform hands-on environmental ...

EHS Auditor / Consultant

Tampa, FL ยท Remote

$98K - $135K/yr

South/Southeast USA - remote with up to 50% travel to client site Contract: Full-time, permanent ... S., including regulatory compliance and risk-based audits * Perform hands-on environmental ...

Coder II - ProFee Surgery

Cape Coral, FL ยท Remote

$20.50 - $27.85/hr

Remote - Florida Department: Coding Work Type: Full Time Shift: Shift 1/8:00:00AM to 4:30:00PM ... Risk Adjustment Coder) CIC (Certified Inpatient Coder) CCS (Certified Coding Specialist) RHIT ...

Coder II - ProFee Surgery

Cape Coral, FL ยท On-site +1

$20.50 - $27.85/hr

Remote - Florida Department: Coding Work Type: Full Time Shift: Shift 1/8:00:00 AM to 4:30:00 PM ... Risk Adjustment Coder) โ€ข CIC (Certified Inpatient Coder) โ€ข CCS (Certified Coding Specialist ...

Coder I - E/M

Cape Coral, FL ยท Remote

$20 - $25.45/hr

Remote - Florida Department: Coding Work Type: Full Time Shift: Shift 1/8:00:00AM to 4:30:00PM ... Risk Adjustment Coder) required -or- CIC (Certified Inpatient Coder) required -or- RHIT (Registered ...

Coder I - E/M

Cape Coral, FL ยท On-site +1

$20 - $25.45/hr

Remote - Florida Department: Coding Work Type: Full Time Shift: Shift 1/8:00:00 AM to 4:30:00 PM ... Risk Adjustment Coder) required -or- CIC (Certified Inpatient Coder) required -or- RHIT (Registered ...

Auditor, Sr Stoploss Claim

Miami Beach, FL ยท On-site +1

$74K - $97K/yr

... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ... Proposes claims adjustments and refunds. * Works claims caseloads. * Aggregate claims experience.

Auditor, Sr Stoploss Claim

Pace, FL ยท On-site +1

$74K - $97K/yr

... remote or hybrid if based near our Dallas office. What You'll Do: * Analyze and adjudicate stop ... Proposes claims adjustments and refunds. * Works claims caseloads. * Aggregate claims experience.

Remote: Open to applicants in the United States, excluding CA, IL, ND, NY, OH, WA, and WY. Hybrid ... Strong understanding of claims data, risk adjustment methodologies, and Health Plan financial ...

Inpatient Coder

Orlando, FL ยท Remote

$19 - $23/hr

This position is remote. Applicants must reside in one of the following states: Alabama, Colorado ... risk adjustment factors (RAF). * Demonstrates an excellent working knowledge of hospital ...

next page

Showing results 1-20

Remote Risk Adjustment Auditor information

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

To thrive as a Remote Risk Adjustment Auditor, you need strong knowledge of medical coding (CPT, ICD-10), healthcare compliance, and experience with risk adjustment methodologies, typically supported by a coding certification such as CPC, CRC, or CCS. Familiarity with electronic health record (EHR) systems, coding audit software, and secure remote work platforms is essential. Attention to detail, analytical thinking, and effective written communication are important soft skills for interpreting complex medical records and collaborating with healthcare providers. These skills ensure accurate risk adjustment coding, regulatory compliance, and optimized reimbursement processes in a remote work environment.

What are some common challenges Remote Risk Adjustment Auditors face, and how can they overcome them?

Remote Risk Adjustment Auditors often encounter challenges such as interpreting complex medical records, staying current with changing coding guidelines, and effectively communicating with team members in a virtual environment. To overcome these, auditors should prioritize ongoing education on coding standards, utilize secure collaboration tools to stay connected with colleagues, and develop strong organizational skills to manage multiple assignments efficiently. Proactively seeking feedback and participating in team meetings can also help maintain accuracy and a sense of community while working remotely.

What is a Remote Risk Adjustment Auditor?

A Remote Risk Adjustment Auditor is a healthcare professional who reviews medical records and documentation from a remote location to ensure accurate coding for risk adjustment purposes. Their work helps health plans and providers comply with government regulations and receive appropriate reimbursement for patient care. They analyze clinical documents to validate diagnoses, identify coding errors, and ensure data integrity. Remote auditors use specialized software and follow strict confidentiality guidelines while working from home or another offsite location.

What is the difference between Remote Risk Adjustment Auditor vs Remote Medical Coder?

AspectRemote Risk Adjustment AuditorRemote Medical Coder
CertificationsCPMA, RAC, or RHITAAPC CPC, CCS, or RHIT
Work EnvironmentInsurance, healthcare auditing firmsHospitals, clinics, insurance companies
Job FocusReviewing documentation for risk adjustment accuracyAssigning medical codes to patient records

Remote Risk Adjustment Auditors and Remote Medical Coders often share certifications and work in healthcare settings. However, auditors focus on reviewing documentation for risk adjustment purposes, while coders assign medical codes directly to patient records. Both roles require healthcare knowledge but serve different functions within the industry.

What are the most commonly searched types of Risk Adjustment Auditor jobs in Florida? The most popular types of Risk Adjustment Auditor jobs in Florida are:
What job categories do people searching Remote Risk Adjustment Auditor jobs in Florida look for? The top searched job categories for Remote Risk Adjustment Auditor jobs in Florida are:
What cities in Florida are hiring for Remote Risk Adjustment Auditor jobs? Cities in Florida with the most Remote Risk Adjustment Auditor job openings:

Lead Auditor, Medicare

Ourhrconnect

Miami Beach, FL โ€ข On-site, Remote

$49K - $60K/yr

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 17 days ago


Job description


Summary
ย Responsible for the coordination and completion of the audit reviews, reviewing audit work papers and reports completed by department staff, distributing reports to management, coordinating auditor's assignments, mentoring and coaching department staff, and assisting the department manager with the direction of the workflow of various risk management activities and special projects.
Description
ย 

This a part time position working approximately 20-30 hours weekly. This is a remote position and the task can be performed at any location.

What You'll Do:

  • Independently and objectively helps plan and execute audits in accordance with professional auditing standards. Performs or supports audits focused primarily on operational controls, asset safeguarding, and compliance with procedures, laws, and regulations. Functions as in-charge auditor of the most complex audit reviews and/or cost reports. May conduct reviews of account reconciliations performed by various financial areas.
  • Identifies and analyzes related key processes, systems, and controls to determine effectiveness. Communicates audit status and results to management, with emphasis on discussing deficiencies and recommending corrective actions. Prepares formal written work papers and reports, documenting audit work performed and expressing conclusion.
  • Assesses desk reviews performed by subordinate auditors to ensure that quality audit work is performed and on-the-job training is provided as necessary. Assists in ensuring that all assigned audits are completed and reviewed in accordance with Generally Accepted Accounting Principles, Generally Accepted Auditing Standards and, Government Auditing Standards. Coordinates the completion of these assignments in a manner which results in timely completion of all assignments in accordance with budget performance requirements as well as departmental interim goals.
  • Directs the day-to-day efforts of assigned audit staff by reviewing and planning assignments, training, and providing leadership and guidance. Assists in the development and revision of work instructions, forms, and procedures.
  • Broadens and maintains working knowledge of applicable laws, regulations, and procedures through self-study programs, on-the-job training, attending seminars and network association's formal training programs. Communicates with internal and external areas as necessary to ensure efficient completion of assigned tasks.


Required Education: Bachelor's in a job related field
Required Work Experience: 7 years auditing or accounting experience with one-year leading audits.
Required Skills and Abilities: Knowledge of the principles and practices of auditing. Ability to analyze and determine the applicability of financial data, to draw conclusions and make appropriate recommendations. Ability to gather information by examining records and documents and to interview individuals concerning those records. Strong interpersonal skills and the ability to work professionally with persons at all levels, and to maintain effective working relationships. Ability to communicate clearly and effectively in oral and written form. Ability to handle sensitive matters on a confidential basis. Knowledge of cost accounting standards and General Accepted Accounting Principles. Knowledge and use of auditing standards and statistical sampling techniques. Good planning and organization skills.
Required Software and Tools: Microsoft Office.
Preferred Licenses and Certificates: Certified Internal Auditor (CIA) or Certified Public Accountant (CPA) or Certified Information Systems Auditor (CISA)
Work Environment: Typical office environment. Some travel between office buildings. Out of town travel may be required.

Our Comprehensive Benefits Package Includes The Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits at the first of the month following 28 days of employment:

  • Subsidized health plans, dental and vision coverage
  • 401k retirement savings plan with company match
  • Life Insurance
  • Paid Time Off (PTO)
  • On-site cafeterias and fitness centers in major locations
  • Education Assistance
  • Service Recognition
  • National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What To Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

SalaryRange:

Range Minimum

$30,227.50

Range Midpoint

$49,040.50

Range Maximum

$60,588.00

Please note that this range represents the pay range for this and other positions that fall into this pay grade. Compensation decisions within the range will be dependent upon a variety of factors, including experience, geographic location, and internal equity.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation.

Some states have required notifications. Here's more information.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation.

Some states have required notifications. Here's more information.