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Remote Risk Adjustment Auditor Jobs in Washington

Global Alliant Inc

AI Engineer

Rockville, MD · Remote

$140K/yr

Remote/Hybrid (subject to contract requirements) Clearance: Must be eligible to obtain and maintain ... risk adjustment, and population health initiatives If interested in applying for the position ...

Global Alliant Inc

AI Engineer

Rockville, MD · On-site +1

Remote/Hybrid (subject to contract requirements) Clearance: Must be eligible to obtain and maintain ... risk adjustment, and population health initiatives If interested in applying for the position ...

System One

Jr Accountant/Auditor

Rockville, MD · Remote

$22 - $25/hr

Hybrid - onsite and remote Hours: 40 hrs a week Security Clearance: None but full background check ... Support risk assessment activities by gathering data and documenting findings. * Perform basic ...

System One

Jr Accountant/Auditor

Rockville, MD · Remote

$22 - $25/hr

Hybrid - onsite and remote Hours: 40 hrs a week Security Clearance: None but full background check ... Support risk assessment activities by gathering data and documenting findings. * Perform basic ...

System One

Jr Accountant/Auditor

Rockville, MD · Remote

$22 - $25/hr

Hybrid - onsite and remote Hours: 40 hrs a week Security Clearance: None but full background check ... Support risk assessment activities by gathering data and documenting findings. * Perform basic ...

Analytica

Eligibility Staff Auditor

Washington, DC · On-site +1

... remote team environment and demonstrate strong analytical, compliance, and audit capabilities ... Utilize data analytics tools to identify patterns, trends, and risk indicators requiring deeper ...

Analytica

Eligibility Staff Auditor

Washington, DC · Remote

The ideal candidate will excel in a collaborative, remote team environment and demonstrate strong ... Utilize data analytics tools to identify patterns, trends, and risk indicators requiring deeper ...

Booz Allen Hamilton, Inc.

Technology Audit Leader

Mclean, VA · On-site +1

$142K - $266K/yr

... technology risk and IT governance * Certified Internal Auditor (CIA) or Certified Information ... Remote : If this position is listed as remote, there may still be occasions when you are required ...

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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 the most commonly searched types of Risk Adjustment Auditor jobs in Washington?

The most popular types of Risk Adjustment Auditor jobs in Washington are:

What are popular job titles related to Remote Risk Adjustment Auditor jobs in Washington?

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

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

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

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

Cities in Washington 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 Washington 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.

HCC Coding Validation Specialists

Columbia, MD • Remote

Careers - Healthcare Resolution Services
See more jobs at Careers - Healthcare Resolution Servicesexternal

Contractor

Re-posted 19 days ago

Job description

Job description:

Job Overview

We are seeking a highly skilled and detail-oriented HCC Coding Analyst to join our healthcare revenue cycle management team. The ideal candidate will possess a comprehensive understanding of hierarchical condition categories (HCC) coding, medical billing, and medical record abstraction. As an HCC Coding Analyst, you will play a vital role in ensuring accurate documentation and coding of patient records to optimize reimbursement from government programs such as the Centers for Medicare and Medicaid Services (CMS). Your expertise in ICD-9, ICD-10, CPT coding, and DRG assignment will contribute significantly to the efficiency and compliance of our billing processes. This position offers an opportunity to work within a dynamic healthcare environment dedicated to accuracy, compliance, and quality patient care.

Duties

  • Review NLP-generated HCC coding output.
  • Validate assigned codes against available documentation.
  • Identify unsupported, inaccurate, or missing codes.
  • Make corrections in the platform or designated workflow.
  • Follow customer coding instructions and project guidelines.
  • Complete assigned records in accordance with agreed production expectations.
  • Utilize electronic health record (EHR) systems and electronic health records (EHR) management tools for coding, record abstraction, and billing workflows.
  • Conduct audits of coded records to identify discrepancies and implement corrective actions to improve coding accuracy.
  • Maintain up-to-date knowledge of changes in medical coding standards, CMS regulations, and healthcare policies affecting reimbursement.
  • Support revenue cycle management initiatives by ensuring precise coding that maximizes appropriate reimbursements while maintaining compliance.

Requirements

  • Proven experience in medical coding with a focus on HCC coding within a healthcare setting.
  • Strong knowledge of ICD-9, ICD-10, CPT coding systems, and DRG assignment processes.
  • Familiarity with medical billing procedures, medical records management, and electronic health record (EHR) systems.
  • Understanding of the CMS guidelines for risk adjustment models and reimbursement policies.
  • Excellent attention to detail with the ability to accurately abstract information from complex medical records.
  • Knowledge of medical terminology, anatomy, pathology, and clinical documentation practices.
  • Prior experience with electronic health records (EHR) management for billing and coding is highly desirable.
  • Effective communication skills for collaborating with clinicians, billing teams, and auditors.

Join our team as an HCC Coding Analyst to ensure precise clinical documentation that supports optimal reimbursement while maintaining regulatory compliance within a fast-paced healthcare environment!

Benefits:

  • Flexible schedule
  • Work Location: Remote

Apply