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Remote Risk Adjustment Auditor Jobs in Riverside, CA

Chubb

Sr. Premium Auditor

Irvine, CA · Remote

The position is primarily remote, with audits completed through a remote physical audit process ... risk managers effectively. * Excellent time management skills to meet deadlines while managing ...

Qcells

Director, Compliance Risk

Irvine, CA · On-site +1

$145K - $195K/yr

Santa Clara, CA or Teaneck, NJ. Remote work may be considered for exceptional cases ... Act as a key liaison with Internal Audit, external auditors, and regulatory examiners. REQUIRED ...

PatientFi

Lending Support Analyst

Irvine, CA · On-site +1

Remote/Hybrid J ob Type: Full-time Key Responsibilities Lending Support Analysts are key performers ... fraud risk • Research and resolve identified CIP concerns via research and engagement with ...

JenaValve

Senior Manager, Clinical Compliance

Irvine, CA · On-site +1

$160K - $170K/yr

Remote - Home Office Summary: Reporting to the Vice President, Clinical Affairs, the Senior Manager ... Develop and execute a risk-based audit program covering internal processes and investigational ...

LSL

Government Assurance Associate

Irvine, CA · On-site +1

$25 - $38/hr

... risk, materiality, and compliance with generally accepted auditing standards via inquiry ... Our remote work environment allows you the freedom to manage your personal commitments while ...

Ensign Services, Inc.

Payroll Resource

Irvine, CA · On-site +1

$20 - $30/hr

Location (Remote): We are seeking candidates based in California to support our Flagstone Market ... Consults with the garnishment/withholding order team to process periodic adjustments when directed.

NextDeavor Inc.

Principal Data Architect

Irvine, CA · Remote

$126K - $214K/yr

Principal Data Architect Full-time Remote Exclusive confidential search -- details shared with ... You will partner with product, engineering, analytics, ML, finance, risk, and customer-facing teams ...

Corvel

Content Marketing Associate

Irvine, CA · Remote

$83K - $139K/yr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Develop and implement a ... Experience in the healthcare or risk management industry (preferred). PAY RANGE: CorVel uses a ...

Corvel

Senior Corporate Paralegal - Contracts

Irvine, CA · Remote

$70K - $116K/yr

This is a hybrid or remote role in the Irvine, CA or Downers Grove, IL office. ESSENTIAL FUNCTIONS ... Ability to identify, analyze, and mitigate contractual risk * Excellent communication and ...

Corvel

Project Manager III

Irvine, CA · On-site +1

$92K - $143K/yr

This is a remote/hybrid work arrangement. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Lead and ... The level may impact the salary range, and these adjustments would be clarified during the offer ...

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... The level may impact the salary range and these adjustments would be clarified during the offer ...

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All JobsRisk Adjustment Auditor JobsRemote Risk Adjustment Auditor JobsRemote Risk Adjustment Auditor Jobs in Riverside, CA

Remote Risk Adjustment Auditor information

See Riverside, CA salary details

$31.8K

$75.8K

$122.6K

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

As of Jul 21, 2026, the average yearly pay for remote risk adjustment auditor in Riverside, CA is $75,776.00, according to ZipRecruiter salary data. Most workers in this role earn between $49,000.00 and $102,800.00 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 Riverside, CA? For Remote Risk Adjustment Auditor jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Remote Risk Adjustment Auditor jobs in Riverside, CA look for? The top searched job categories for Remote Risk Adjustment Auditor jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Remote Risk Adjustment Auditor jobs? Cities near Riverside, CA with the most Remote Risk Adjustment Auditor job openings:
Remote Risk Adjustment Auditor jobs near you

Risk Adjustment Coding Specialist II - Orange County

Astrana Health, Inc.

Orange, CA • Remote

$70K - $85K/yr

Full-time

Posted 28 days ago

Job description

Description
We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Orange County market.  In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You’ll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you’ll track and report on key performance metrics—such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success. 
We are seeking candidates who have experience with provider education and at least 3-5 years of risk adjustment experience! This position requires travel to provider offices up to 75% of the time OC.
Our Values: 
  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence
  • Be Innovative
  • Work As One Team

What You'll Do
  • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company
  • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC) 
  • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines 
  • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing
  • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
  • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives.
  • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work.
  • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager.
  • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I
  • Other duties as assigned

Qualifications
  • Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification -  Certified Coding Specialist (CCS-P), CCS, or CPC.
  • At least 3 years of experience in risk adjustment coding and/or billing experience required
  • Reliable transportation/Valid Driver’s License/Must be able to travel up to 75% of work time
  • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
  • Excellent presentation, verbal and written communication skills, and ability to collaborate 
  • Must possess the ability to educate and train provider office staff members
  • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.
You're great for this role if:    
  • Strong billing knowledge and/or Certified Professional Biller (CPB) through APPC
  • Certified Risk Adjustment Coder (CRC) and/or Risk Adjustment coding experience
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
  • Strong PowerPoint and public speaking experience
  • Ability to work independently and collaborate in a team setting
  • Experience with Monday.com
  • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting

Environmental Job Requirements and Working Conditions
  • The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
  • This role follows a hybrid work structure where the expectation is to work on the field and at home on a weekly basis. This position requires up to 75% travel to provider offices in Orange County. 
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.    

Additional Information:     
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.