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Remote Risk Adjustment Auditor Jobs in New Jersey

Altegra Health

Remote Certified Coder

Atlantic City, NJ · Remote

$22.50 - $31/hr

Company Description Altegra Health is a total solutions partner for healthcare data auditing and ... Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ...

Altegra Health

Remote Certified Coder

Atlantic City, NJ · On-site +1

$22.50 - $31/hr

Company Description Altegra Health is a total solutions partner for healthcare data auditing and ... Altegra Health specializes in: 1. CMS HCC Risk Adjustment 2. HEDIS 3. Medical Record Reviews ...

Ennoble Care

Sr. Medical Economics Analyst

Marlton, NJ · Remote

Thorough understanding of and hands-on experience with Medicare risk adjustment and CMS-HCC models ... Fully Remote (with up to 10% travel) This position requires the ability to work with sensitive ...

New

Monogram Health

Market Physician Executive

Newark, NJ · Remote

This position will be remote within the designated market with occasional in-home patient treatment ... risk adjustment. * Current state medical license without restrictions to practice and free of ...

Qcells

Director, Compliance Risk

Teaneck, NJ · On-site +1

$145K - $195K/yr

Santa Clara, CA or Teaneck, NJ. Remote work may be considered for exceptional cases ... Act as a key liaison with Internal Audit, external auditors, and regulatory examiners. REQUIRED ...

Monogram Health

Market Physician Executive

Trenton, NJ · Remote

This position will be remote within the designated market with occasional in-home patient treatment ... risk adjustment. * Current state medical license without restrictions to practice and free of ...

Crum & Forster

Premium Audit CSR - Remote

Morristown, NJ · On-site +1

$51K - $62K/yr

Our claims and risk engineering services are recognized as among the best in the industry. Our most ... Ability to clearly explain audit findings and requirements to policyholders, agents, and auditors.

Crum & Forster

Premium Audit CSR - Remote

Morristown, NJ · On-site +1

$51K - $62K/yr

Our claims and risk engineering services are recognized as among the best in the industry. Our most ... Ability to clearly explain audit findings and requirements to policyholders, agents, and auditors.

Crum & Forster

Premium Audit CSR - Remote

Morristown, NJ · On-site +1

Our claims and risk engineering services are recognized as among the best in the industry. Our most ... Ability to clearly explain audit findings and requirements to policyholders, agents, and auditors.

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Remote Risk Adjustment Auditor information

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 are the key skills and qualifications needed to thrive as a remote risk adjustment auditor?

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 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 popular job titles related to Remote Risk Adjustment Auditor jobs in New Jersey?

For Remote Risk Adjustment Auditor jobs in New Jersey, the most frequently searched job titles are:

What job categories do people searching Remote Risk Adjustment Auditor jobs in New Jersey look for?

The top searched job categories for Remote Risk Adjustment Auditor jobs in New Jersey are:

What cities in New Jersey are hiring for Remote Risk Adjustment Auditor jobs?

Cities in New Jersey with the most Remote Risk Adjustment Auditor job openings:

Remote Risk Adjustment Auditor jobs near you
Infographic showing various Remote Risk Adjustment Auditor job openings in New Jersey as of August 2026, with employment types broken down into 91% Full Time, 3% Part Time, and 6% Contract. Highlights an 100% Remote job distribution.

Remote Certified Coder

Altegra Health

Atlantic City, NJ • Remote

$22.50 - $31/hr

Temporary

Re-posted 28 days ago

Job description

Company Description

Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in:

1. CMS HCC Risk Adjustment

2. HEDIS

3. Medical Record Reviews (Accreditation)

4. And more


Job Description

These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines).


Responsibilities:  

Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC group assignments as applicable.

Assign Altegra Health Flagged Event codes when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes.

Remain current on medical coding guidelines and reimbursement reporting requirements.

Check chart assignments every day and report accurately all hours worked on a weekly basis.

Report work-related concerns to assigned Coder Advocate and if not adequately addressed to Sr. Manager of Clinical Operations. 

Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines.

Comply with HIPAA laws and regulations.

Participate in testing and training as required by the Company.

Qualifications:  

Active nursing license (RN or LPN) and/or certified coder certification through AHIMA or AAPC required

At least one years' experience as a medical coder/abstractor.

Extensive knowledge of ICD-9-CM outpatient diagnosis coding guidelines (with knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements is preferred);

Ability to code using an ICD-9-CM code book (without using an encoder);

Strong clinical skills related to chronic illness diagnosis, treatment and management;

Reliability and a commitment to meeting tight deadlines (24-hour turnaround time on all assigned charts);

Personal discipline to work remotely without direct supervision;

Exemplary attention to detail and completeness-all medical coders must maintain minimum QA passing requirements based on HCC scoring model(HCCx < or equal to 5 and HCCm < or equal to 5);

Computer proficiency (including MS Windows, MS Office, and the Internet);

Must have high-speed Internet access, a home computer with a current Windows operating system, MS Internet Explorer (version 6.0.2 or better), and Adobe 6.0 or better;

Strong organization skills; interpersonal and customer service skills; written and oral communication skills; and analytical skills;

Knowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical chart documentation.


Qualifications

1 year certified remote coding experience

Additional Information

All your information will be kept confidential according to EEO guidelines.

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