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Remote Risk Adjustment Auditor Jobs in Boca Raton, FL

RELX

Senior Site Reliability Engineer II

Boca Raton, FL · On-site +1

$125K - $209K/yr

LexisNexis Risk Solutions is the essential partner in the assessment of risk. Within our Business ... If not, this role is fully remote. We do not restrict applicants based on job site or posting ...

Novoco

Audit/Tax Senior

Plantation, FL · On-site +1

$80K - $98K/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 ...

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Remote Risk Adjustment Auditor information

See Boca Raton, FL salary details

$28.9K

$68.9K

$111.5K

How much do remote risk adjustment auditor jobs pay per year?

As of Aug 16, 2026, the average yearly pay for remote risk adjustment auditor in Boca Raton, FL is $68,927.00, according to ZipRecruiter salary data. Most workers in this role earn between $44,600.00 and $93,500.00 per year, depending on experience, location, and employer.

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 popular job titles related to Remote Risk Adjustment Auditor jobs in Boca Raton, FL?

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

What job categories do people searching Remote Risk Adjustment Auditor jobs in Boca Raton, FL look for?

The top searched job categories for Remote Risk Adjustment Auditor jobs in Boca Raton, FL are:

What cities near Boca Raton, FL are hiring for Remote Risk Adjustment Auditor jobs?

Cities near Boca Raton, FL with the most Remote Risk Adjustment Auditor job openings:

Remote Risk Adjustment Auditor jobs near you

Risk Adjustment Coordinator, Remote, Baptist Health Integrated Care, FT, 08A-4:30P

Baptist Health South Florida

Boca Raton, FL • Remote

$25.37 - $32.22/hr

Full-time

Posted 5 days ago

Baptist Health South Florida rating

8.1

Company rating: 8.1 out of 10

Based on 99 frontline employees who took The Breakroom Quiz

1st of 24 rated health and beauty retailers

Job description

The Risk coding Regional Auditor must support the Director of risk coding along with other team professionals working to provide pre and post visit review analysis for provider practices while providing risk coding education to healthcare providers to improve practice risk scores. He or she must relate in a professional manner to co-workers, hospital administrators, physicians, Medicare beneficiaries, and others to represent the department and the health system while working closely with other departments to achieve favorable outcomes. This position is responsible for chart review and up-coding workflows. The position will also require coordination of projects to ensure the success of the goals within the CIN organization. Supports the mission, vision, values and strategic goals of Baptist South Florida.Estimated pay range for this position is $25.37 - $32.22 / hour depending on experience.Degrees:
  • High School,Cert,GED,Trn,Exper.
Licenses & Certifications:
  • AAPC Certified Risk Adjustment Coder.
  • AAPC Certified Professional Coder.
  • AAPC Certified Professional Medical Auditor.
Additional Qualifications:
  • Bachelors of Science degree preferred.
  • Certified Professional Coder and/ or Certified Risk Adjustment Coder (CRC).
  • CPMA certification must be obtained within 1 year of Hire.
  • Required completion of an accredited certified coding specialist program.
  • 2 years of clinic or hospital experience and/ or managed care experience.
  • 1 years of experience in Risk Adjustment and HEDIS/Stars.
  • Ability to interpret, analyze and abstract data/documentation.
  • Comprehensive Knowledge of ICD-10-CM codes, Category II codes, COA measures, CMS documentation requirements, state and federal regulations including compliance and reimbursement and the impact of diagnosis coding on risk adjustment payment models.
  • Ability to identify HCC improvement opportunities and educate clinical providers on proper clinical documentation, compliance, and coding guidelines.
  • Intermediate level of proficiency in MS Office - Excel, PowerPoint, and Word.
  • Ability to defend coding decisions to both internal and external audits.
  • Strong organizational skills in multiple settings, as well as the ability to exercise judgement and initiative.
  • Ability to work in a continuously changing environment.
Minimum Required Experience: 5 Years

What Baptist Health South Florida employees say

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About Baptist Health South Florida

Sourced by ZipRecruiter

Baptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 27,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. A not-for-profit organization supported by philanthropy and committed to its faith-based charitable mission of medical excellence, Baptist Health has been recognized by Fortune as one of the 100 Best Companies to Work For in America and by Ethisphere as one of the World's Most Ethical Companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Miami, FL, US

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