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Remote Risk Adjustment Auditor Jobs in Boca Raton, FL

Renishaw

Senior Site Reliability Engineer II

Boca Raton, FL · On-site +1

$104K - $174K/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 ...

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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 Jun 9, 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 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 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 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
Medical Record Retrieval Specialist - Palm Beach, FL

Medical Record Retrieval Specialist - Palm Beach, FL

Humana

Pompano Beach, FL • Remote

$40K - $52K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 7 days ago

Humana rating

8.0

Company rating: 8.0 out of 10

Based on 252 frontline employees who took The Breakroom Quiz

145th of 260 rated insurance

Job description

Become a part of our caring community
The Medical Record Retrieval Specialist (Risk Adjustment Representative) travels to provider offices within the region and scans medical records into a secure system. The records are reviewed by Humana's Coding staff.
Travel in North Broward and Palm Beach counties, FL and surrounding areas

Duties and Responsibilities

  • Travel up to 50% of the time primarily in N. Broward and Palm Beach Counties in FL with the possibility of occasional overnight stays.
  • Collect medical records by using a laptop and portable scanner to scan paper records and/or download electronic medical records to a thumb drive to meet production goals.
  • Visits to physician offices in a timely, efficient manner to meet all deadlines.
  • Answering phones, electronically faxing, internet search and email utilization.
  • Research and updates site information by utilizing CarePlus internal systems.
  • Follows CarePlus and HIPAA confidentiality standards to protect the confidentiality of member information.
  • Demonstrates a professional and courteous manner when communicating with others with the ability to clearly and accurately state the agreed upon resolution.

Use your skills to make an impact

Required Qualifications

  • MUST reside in Broward or Palm Beach counties.
  • 1 or more years of telephonic environment experience and/or customer service in an office setting.
  • Proficiency in Microsoft Office Word and Excel.
  • Ability to travel locally up to 50% of the time.
  • Ability to travel overnight occasionally within the region.
  • Must have reliable car transportation.
  • Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems.
  • This job is part of Humana's Driver safety program and therefore requires an individual to have a valid State Driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits and requires running a Motor Vehicle Report as part of the background check process.

Preferred Qualifications

  • 1 or more years of experience with Medical Record or Health information retrieval experience In a Hospital, Healthcare and/or Medical Office setting.
  • Knowledge and experience in managed care.
  • Medical terminology.
  • Experience and comfort with EMR (Electronic Medical Records) systems.
  • Medical Record retrieval experience.
  • Bilingual English and Spanish.
  • Healthcare experience.

Work-At-Home Requirements

  • Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
  • A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
  • Satellite, cellular and microwave connection can be used only if approved by leadership.
  • A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

SSN Alert Statement

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$40,000 - $52,300 per year


Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties.About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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About Humana

Sourced by ZipRecruiter

Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Louisville, KY, US

Year founded

1961

Social media

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