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Remote Risk Adjustment Auditor Jobs in Tennessee

Schedule and perform external and/or remote assessments of LabConnect critical vendors on a risk-based schedule. * Update and maintain QRS Key Performance Indicators and other metrics as necessary ...

This role will be a Remote role but must be based within the United States. The Manager, compliance ... risk-based healthcare compliance and privacy auditing programs to detect and remediate violations.

WBL has a fully remote, multinational workforce of ~200 and a proven, seasoned leadership team ... Build succession planning and cross-training practices to reduce key-person risk within the ...

Showing results 41-46

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 Tennessee? The most popular types of Risk Adjustment Auditor jobs in Tennessee 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:

Quality Audit Specialist

LabConnect

Johnson City, TN • On-site, Remote

Full-time

Medical, Life, Retirement, PTO

Posted 12 days ago


Job description

Overview
LabConnect improves lives by partnering with pharmaceutical and biotech companies, and clinical research organizations (CROs) to accelerate the development of new medicines around the world.
We are an independent, global, one-stop-shop focused on delivering Central Laboratory Services that are tailor-made, timely and flexible to meet the evolving study demands of traditional to increasingly complex trials. Additionally, we provide Functional Service Provider (FSP) Solutions, supporting our clients with scientific and technical expertise, acting as an extension of their team, coordinating all laboratory related needs, advising on strategies for lab data collection and providing end-to-end analytical and logistical solutions.
Job Summary
The Quality Audit Specialist executes internal and external audits, supports vendor and client audits, and drives post-audit actions to completion, and is responsible for assisting Quality Management in monitoring GCP regulatory compliance and quality in clinical trial operational activities. The Quality Audit Specialist role will frequently interact with cross functional groups and external partners to ensure compliance initiatives are met.
This is a fully remote role.
Essential Duties and Responsibilities
  • Schedule and organize internal and external assessments of LabConnect by QRS or Clients.
  • Schedule and perform internal assessments including, but not limited to, computer systems validations, Equipment calibration and validation review, internal audits, directed inspections and investigations, gap analyses, etc.
  • Schedule and perform external and/or remote assessments of LabConnect critical vendors on a risk-based schedule.
  • Update and maintain QRS Key Performance Indicators and other metrics as necessary for assuring timely decision making and updating management.
  • Perform document control activities within eQMS including but not limited to SOP creation, revision, obsolescence, approvals.
  • Assist Project Managers and operational management with quality and regulatory advice and assistance when required.
  • Track, trend and monitor actions pertaining to audits and compliance activities and other activities in support of the global QMS.
  • Compose timely routine correspondence to internal and external stakeholders.
  • Organize and maintain electronic and hard-copy file system, and f iles records as appropriate.
  • Independently conducts research and prepares statistical reports.
  • Coordinate and arrange meetings, prepare agendas, reserve and prepare facilities, and record and transcribe minutes of meetings.
  • Perform frequent assessments of quality system for continuous improvement initiatives.
  • Train new hires on job specific duties as deemed appropriate
  • Act as QRS representative in internal and external meetings with key stakeholders and/or Clients.
  • Organize, maintain, and archive electronic and hard-copy quality records in accordance with document control and record retention requirements; ensure accurate filing, traceability, and accessibility of controlled documents,
  • Support the electronic Quality Management System (eQMS) by assisting with the creation, review, issuance, revision, and change control of quality documents.
  • Utilize Jira to log, monitor, trend, and report quality-related actions, Quality Events, client complaints, audit findings, and CAPAs to ensure timely closure and visibility.
  • Maintain quality logs, metrics, and dashboards to support management review, audits, and continuous improvement initiatives, ensuring compliance with internal procedures and regulatory expectations.
  • Perform other related duties and tasks as necessary or as assigned by Quality Management.

Education and Experience
  • Bachelor's degree with 4-6 years in quality-related roles, specializing in regulatory compliance required
  • Experience with clinical trials audit activities (hosting audits and conducting audits)
  • eQMS software experience preferred (Veeva Vault is ideal)

Skills and Ability
  • Excellent attention to detail, strong planning, and problem-solving skills.
  • Excellent organizational and time management skills.
  • Excellent listening and verbal comprehension skills ensuring clarity in professional communication and audit readiness.
  • Ability to make well-thought-out decisions and adapt to changing environments and requirements.
  • Self-motivation and ability to work well independently as well as using a collaborative team approach.
  • Ability to adhere to established timelines, processes, and procedures.
  • Ability to work independently and collaboratively, balancing multiple projects with attention to detail.

Supervisory Responsibilities: None
Physical Demands:
While performing the duties of this job, the occupant is regularly required to:
  • Prolonged periods of sitting at a desk and working on a computer.
  • Prolonged use of computer and headphones for conference calls.
  • Communicate effectively via phone, video, and email.
  • Specific vision abilities required by this job include close vision, color vision, depth perception and ability to adjust focus.
  • Use hands and fingers to operate a computer and other office equipment.
  • Walk and/or reach with hands and arms.
  • Read text of various sizes
  • Specific vision abilities required by this job include close vision, color vision, depth perception and ability to adjust focus.
  • Communicate with others and hear.
  • Lift, pull and/or push up to 25 pounds.

Travel Requirements: Up to 25%
Join our team and discover how your work can impact patients' lives around the world!
Some of the Perks our LabConnectors Love:
  • Financial Security (Base Pay, 401k Match and Possible Annual Bonus Eligibility)
  • Health Benefits beginning on date of hire
  • PTO plan, plus 11 Paid Company Holidays, and 1 Day to Volunteer in your community
  • Short and Long-Term Disability, Life Insurance, and AD&D
  • We celebrate our differences, which enriches our culture!

In addition to great perks and challenging work assignments, we invest in our people with career growth opportunities, globally. We believe in a friendly and collaborative environment with open lines of communication. While living out our values of People First, Quality Focused, Customer Centered, Technology Driven, and Accountability Always.
We are proud to be an Equal Employment Opportunity Employer and value the diversity of our workforce. We do not discriminate on the basis of race, gender, age, disability, religion, sexual orientation, or any other protected characteristic. To learn more about equal employment opportunity, please view the posters here: https://www.dol.gov/agencies/whd/posters
LabConnect also prioritizes the privacy and security of your personal data. All candidate information is handled in accordance with General Data Protection Regulation (GDPR). To learn more, please review our Privacy Notice on our website, by navigating to https://www.labconnect.com/
If you need assistance to complete your job application, search for a job opening, or submit an online application at LabConnect, please email talent@labconnect.com or call +1 (423) 722-3155.