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Remote Risk Adjustment Auditor Jobs in Tennessee

Altegra Health

Remote Certified Coders

Memphis, TN · Remote

$21.75 - $29.75/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 Coders

Memphis, TN · On-site +1

$21.75 - $29.75/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 ...

Humana

Clinical Coding Educator

Lebanon, TN · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Clinical Coding Educator

Etowah, TN · On-site +1

$59.30K - $80.90K/yr

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Clinical Coding Educator

Hermitage, TN · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Clinical Coding Educator

Harriman, TN · On-site +1

$59.30K - $80.90K/yr

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Clinical Coding Educator

Athens, TN · On-site +1

$59.30K - $80.90K/yr

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Clinical Coding Educator

Hermitage, TN · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Clinical Coding Educator

Smyrna, TN · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Clinical Coding Educator

Smyrna, TN · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Clinical Coding Educator

Sewanee, TN · On-site +1

$59.30K - $80.90K/yr

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Clinical Coding Educator

Bristol, TN · On-site +1

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Clinical Coding Educator

Mc Minnville, TN · On-site +1

$59.30K - $80.90K/yr

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

Humana

Clinical Coding Educator

Sevierville, TN · On-site +1

$59.30K - $80.90K/yr

Will report to the Manager, Medicare Risk Adjustment As the Clinical Coding Educator / Coding ... While this is a remote position, occasional travel to Humana's offices for training or meetings may ...

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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 Tennessee? The most popular types of Risk Adjustment Auditor jobs in Tennessee are:
What are popular job titles related to Remote Risk Adjustment Auditor jobs in Tennessee? For Remote Risk Adjustment Auditor jobs in Tennessee, the most frequently searched job titles are:
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What cities in Tennessee are hiring for Remote Risk Adjustment Auditor jobs? Cities in Tennessee with the most Remote Risk Adjustment Auditor job openings:
Remote Risk Adjustment Auditor jobs near you

Remote Medicare Risk Adjustment Coding Expert

American Health Plans Inc.

Franklin, TN • Remote

$18.50 - $24.75/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

American Health Plans is seeking a Medicare Risk Adjustment Coding Specialist to conduct coding audits and perform post-payment coding reviews to ensure compliance with CMS regulations. This remote role requires strong knowledge of ICD-9 and ICD-10 coding, experience with Medicare and Medicaid claims, and excellent communication skills. Ideal candidates will be certified in coding (CPC or CRC) and possess at least two years of relevant experience in claims processing or coding auditing.

A collaborative mindset and the ability to work independently are essential for success in this role. #J-18808-Ljbffr

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