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Remote Risk Adjustment Auditor Jobs in Ohio (NOW HIRING)

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 ยท 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 ยท 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 ยท 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 ...

Senior Underwriting Consultant

Delaware, OH ยท 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 ยท 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 ...

Consumer Card Product Director

Columbus, OH ยท On-site +1

$225K - $235K/yr

Works closely with Risk Administration, Underwriting, Compliance, Legal, Ops, Phone Bank, and ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

Consumer Card Product Director

Columbus, OH ยท On-site +1

$218K - $229K/yr

Works closely with Risk Administration, Underwriting, Compliance, Legal, Ops, Phone Bank, and ... Remote roles will also have the opportunity to come together in our offices for moments that matter.

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 ...

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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 Ohio? The most popular types of 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 89% Full Time, and 11% Part Time. Highlights an 100% Remote job distribution.
Actuarial Technical Consultant - Personal Lines Pricing - REMOTE

Actuarial Technical Consultant - Personal Lines Pricing - REMOTE

Veterinary Pet Insurance

Columbus, OH โ€ข Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 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.

Actuarial Technical Consultant - Personal Lines Pricing

Position Overview: We are seeking a highly skilled Actuarial Technical Consultant to join our personal lines pricing team. This role is crucial in supporting the pricing function by conducting state product reviews, providing risk segmentation and pricing recommendations, and assessing rate adequacy to promote financial success. The ideal candidate will bring new perspectives and innovative ideas to continue delivering high-level actuarial services to our business partners.

Key Responsibilities:

  • Conduct state product reviews and assess rate adequacy to ensure financial success.

  • Enhance rating plans, establish risk segmentation and provide pricing recommendations.

  • Lead pricing analysis and engagement on our large and complex markets.

  • Introduce new perspectives and innovative ideas to enhance actuarial services.

  • Analyze results and present findings to internal product, actuarial, and underwriting teams.

Essential Skills:

  • Strong foundation in actuarial science and mathematics.

  • Skills in velocity, agility, critical thinking, and problem-solving.

  • Experience with Microsoft Excel and PowerPoint.

Preferred Experience and Skills:

  • Personal Lines experience is highly preferred.

  • Proficiency in SQL, DataBricks, Python, and R.

  • Exposure to predictive modeling is a plus.

Work Arrangements:

  • This role can be staffed fully remotely.

#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 a Technical Consultant, you'll be an actuarial technical expert for planning, driving, communicating and executing projects that may impact multiple lines of business and/or administrative areas. Additionally, you will provide expertise, including consultation and recommendations, for ratemaking or reserving purposes.

Job Description

Key Responsibilities:

  • Has in depth knowledge of actuarial methodologies the ability to source and manipulate complex data within standard requirements.

  • Conducts complex analyses, adhering to actuarial standards, by selecting appropriate data sources, making assumptions, recognizing considerations, and developing recommendations. Accountable for resolving unreasonable results/non-optimal solutions using experience and professional judgment.

  • 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.

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

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

  • Applies data mining techniques used to identify new relationships in data and makes recommendations based on findings. Builds and validates models in different software packages. Explores the use of new software packages. Has practical use of predictive modeling.

May perform other responsibilities as assigned.

Reporting Relationships: Reports to Actuarial leader.

Typical Skills and Experiences:


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

Experience: Generally, seven years of related experience in actuarial and statistical support role.

Knowledge, Abilities and Skills: Proven general 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 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 the Nationwide Values.

Job Conditions:


Overtime Eligibility: Exempt (Not Eligible)

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 07/29/2026. 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 Actuarial Technical Consultant, PC : $97,000.00-$180,000.00The expected starting salary range for Actuarial Technical Consultant, PC : $97,000.00 - $145,000.00