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Remote Risk Adjustment Auditor Jobs in Ohio (NOW HIRING)

This role is responsible for monitoring, analyzing, and auditing financial transactions of high ... practices, and risk; and develop an overall and effective audit program. Develop and present ...

Financial Audit Senior Consultant

Delaware, OH · Remote

$110K/yr

This role is responsible for monitoring, analyzing, and auditing financial transactions of high ... practices, and risk; and develop an overall and effective audit program. Develop and present ...

We are open to remote candidates. In this role, the Environmental Engineer is responsible for ... Compliance Monitoring & Risk Management * Conduct environmental audits, inspections, and risk ...

Audit/Tax Senior

Cleveland, OH · On-site +1

$78K - $96K/yr

Some positions at Novogradac may be open to remote or hybrid work arrangements depending on ... Ability to accept constructive feedback from management and make adjustments as directed * Ability ...

Senior Underwriting Consultant

Delaware, OH · Remote

$93K - $110K/yr

This is a remote role open to any location in continental US Manulife is a leading international ... May process all aspects of auditing, formal appeal reviews and contestable claim review. * Audit ...

Senior Underwriting Consultant

New Hampshire, OH · Remote

$88K - $104K/yr

This is a remote role open to any location in continental US Manulife is a leading international ... May process all aspects of auditing, formal appeal reviews and contestable claim review. * Audit ...

Collaborate with external auditors and ensure SOX compliance for tax processes. * Support financial ... This position is primarily remote, offering the flexibility to work from home while staying ...

... risk and compliance discipline. Provides customer service to clients/prospects to ensure a thorough ... Coordinates product setup and client training for services such as ACH/wires, remote deposit ...

Showing results 21-40

Remote Risk Adjustment Auditor information

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 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 Ohio? The most popular types of Risk Adjustment Auditor jobs in Ohio are:
What are popular job titles related to Remote Risk Adjustment Auditor jobs in Ohio? For Remote Risk Adjustment Auditor jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Remote Risk Adjustment Auditor jobs in Ohio look for? The top searched job categories for Remote Risk Adjustment Auditor jobs in Ohio are:
What cities in Ohio are hiring for Remote Risk Adjustment Auditor jobs? Cities in Ohio with the most Remote Risk Adjustment Auditor job openings:
Infographic showing various Remote Risk Adjustment Auditor job openings in Ohio as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Sr Actuarial Consultant - Personal Lines State Pricing - REMOTE

Nationwide

Columbus, OH • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 16 days ago


Job description

As a team member in Finance at Nationwide, a Fortune 100 company with nearly $70 billion in annual sales, the opportunities are endless! Let Nationwide help create your career journey! At Nationwide, "on your side" goes beyond just words. Our customers are at the center of everything we do and we're looking for associates who are passionate about delivering extraordinary care.

Senior Actuarial Consultant - Personal Lines Pricing

About the Role:

Join our dynamic team as a Senior Actuarial Consultant specializing in Personal Lines Pricing. This pivotal role involves owning pricing decisions for complex states and collaborating closely with business partners. This is a key member of our leadership team, driving a partnership-driven approach.

Key Responsibilities:

  • Lead pricing decisions for complex states, ensuring alignment with business objectives.
  • Serve as a technical expert in actuarial methodologies, conducting comprehensive analyses.
  • Develop and implement cross-functional work plans, leading peer reviews to ensure quality and accuracy.
  • Engage with business partners to assess and enhance technical abilities and communication skills.

Qualifications:

  • ACAS is required; candidates with or working towards FCAS are preferred.
  • Minimum of six years of actuarial experience, with a strong background in pricing and product line knowledge.
  • Proficiency in SQL, Python, Snowflake, and Databricks is preferred.
  • Demonstrated ability to adapt to a fast-paced environment and manage changing priorities effectively.

Cultural Fit:

  • We seek candidates who are adaptable, proactive, and eager to take on leadership roles.
  • The ideal candidate will be a consumer of diverse actuarial work products and thrive in a collaborative, fast-paced setting.

Why Join Us?

  • Be part of a forward-thinking team that values innovation and collaboration.
  • Enjoy the flexibility of a remote or hybrid work environment while contributing to impactful projects.
  • Engage in a role that offers growth opportunities and the chance to influence key pricing decisions.

Apply Now:

If you are a results-driven actuarial professional with a passion for pricing and leadership, we invite you to apply for this exciting opportunity. Join us in shaping the future of personal lines pricing.

#LI-SM1

#LI-remote

Job Description Summary

Our Property and Casualty (P&C) Actuarial team members have opportunities to use state-of-the-art tools, are encouraged to innovate and learn to master actuarial methodologies. If this sounds like a place you could thrive, then we want to know more about you!
As an Actuarial Sr Consultant, you'll need to have detailed familiarity with business operations, systems, and actuarial methodologies. We'll count on you to be adept at complex actuarial techniques and work independently to combine advanced actuarial and business knowledge to provide high-level analysis. Additionally, you'll have expertise to provide consultation and recommendations on deliverables and maintain detailed documentation of actuarial models and analyses. You'll work independently and may lead others.

Job Description

Key Responsibilities:

  • Acts as a technical expert of actuarial methodologies allowing the ability to source and manipulate data within standard requirements.

  • Conducts complex analyses, adhering to actuarial standards, by selecting appropriate data sources, making assumptions, recognizing considerations, and developing recommendations. Resolves unreasonable results/non-optimal solutions using experience and professional judgment. Begins using results to influence decisions at a higher level.

  • Accurately documents assumptions, methods, sources, and considerations in an organized fashion.

  • Prepares and presents actuarial findings and documents that are suitable for technical and non-technical audiences at the senior Actuarial leadership level. May professionally represent company's position with regulators, auditors, and external vendors. May negotiate within defined parameters.

  • Develops cross functional work plans and ensures accurate work product is delivered.

  • Leads cross functional peer reviews to increase collaboration, ensure quality work, and drive innovation.

  • Builds business relationships and leads cross functional communication with team members, customers, and business partners.

  • Leads onboarding and training for new associates on standard work processes. Assists in creating new training materials.

  • Applies data mining techniques used to identify new relationships in data and make recommendations based on findings. Has expert ability or knowledge of modeling, validation, and predictive modeling. Explores the use of new software packages and makes recommendations.

May perform other responsibilities as assigned.

Reporting Relationships: Reports to an Actuarial, Analytics, or Risk Management leader.

Typical Skills and Experiences:

Education: Undergraduate degree in actuarial science, mathematics, statistics, data science or similar background requiring modeling, programming or quantitative analysis.

License/Certification/Designation: Generally attained ACAS and is working towards FCAS or recently attained FCAS. PLEASE REFER TO THE NATIONWIDE PC INSURANCE COMPANY ACTUARIAL STUDENT PROGRAM FOR ADDITIONAL INFORMATION.

Experience: Generally, six or more years of actuarial experience.

Knowledge, Abilities and Skills: Detailed knowledge of actuarial business functions, statistical methods of analysis, actuarial models, actuarial software and databases. Proficient in Microsoft Office products, analytical software and programming languages. Should have basic competencies including command skills, strategic agility, delegation, motivating others, business perspective and accounting. Should have highly-developed competencies in business understanding, problem solving, customer focus, dealing with ambiguity, drive for results, and learning ability.

Other criteria, including leadership skills, competencies and experiences may take precedence.

Staffing exceptions to the above must be approved by the hiring manager's leader and HR Business Partner.

Values: Regularly and consistently demonstrates Nationwide Values.

Job Conditions:

Overtime Eligibility: Not Eligible (Exempt)

Working Conditions: Normal office environment.

ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.

We currently anticipate accepting applications until 09/06/2026. However, we encourage early submissions, as the posting may close sooner if a strong candidate slate is identified before the deadline.

Benefits

We have an array of benefits to fit your needs, including: medical/dental/vision, life insurance, short and long term disability coverage,paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date, nine paid holidays, 8 hours of Lifetime paid time off, 8 hours of Unity Day paid time off, 401(k) with company match, company-paid pension plan, business casual attire, and more. To learn more about the benefits we offer, click here.

Nationwide is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive culture where everyone feels challenged, appreciated, respected and engaged. Nationwide prohibits discrimination and harassment and affords equal employment opportunities to employees and applicants without regard to any characteristic (or classification) protected by applicable law.

This position could be filled within any of the lower 48 U.S. states.Smoke-Free Iowa Statement: Nationwide Mutual Insurance Company, its affiliates and subsidiaries comply with the Iowa Smokefree Air Act. Smoking is prohibited in all enclosed areas on or around company premises as well as company issued vehicles. The company offers designated smoking areas in which smoking is permitted at each individual location. The Act prohibits retaliation for reporting complaints or violations. For more information on the Iowa Smokefree Air Act, individuals may contact the Smokefree Air Act Helpline at 888-944-2247.
For NY residents please review the following state law information: Notice of Employee Rights, Protections, and Obligations LS740 (ny.gov) https://dol.ny.gov/system/files/documents/2022/02/ls740_1.pdf

NOTE TO EMPLOYMENT AGENCIES:

We value the partnerships we have built with our preferred vendors. Nationwide does not accept unsolicited resumes from employment agencies. All resumes submitted by employment agencies directly to any Nationwide employee or hiring manager in any form without a signed Nationwide Client Services Agreement on file and search engagement for that position will be deemed unsolicited in nature. No fee will be paid in the event the candidate is subsequently hired as a result of the referral or through other means.

Nationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. If a Sales job, Sales Incentives, based on performance goals are possible in addition to this range. Note on Compensation for Part-Time Roles: Please be aware that the salary ranges listed below reflect full-time compensation. Actual compensation may be prorated based on the number of hours worked relative to a full-time schedule.The national salary range for Sr Consultant, Actuarial - P&C : $118,000.00-$222,000.00The expected starting salary range for Sr Consultant, Actuarial - P&C : $118,000.00 - $178,000.00