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Remote Risk Adjustment Auditor Jobs (NOW HIRING)

Mercor

HCC Coding Leader - Risk Adjustment

New York, NY · Remote

$110/hr

Remote Role Responsibilities * Lead risk adjustment and HCC coding operations across Medicare Advantage , Medicaid , and ACA risk adjustment programs. * Evaluate AI-generated HCC coding assignments ...

AAPC

PACE Risk Adjustment Coder

Salt Lake City, UT · On-site +1

This is a remote contract position. Job Duties: * Code medical records to validate ICD-10-CM codes for PACE Risk Adjustment * Meet department production and quality standards * Research regulatory ...

AAPC

PACE Risk Adjustment Coder

Salt Lake City, UT · Remote

This is a remote contract position. Job Duties: * Code medical records to validate ICD-10-CM codes for PACE Risk Adjustment * Meet department production and quality standards * Research regulatory ...

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

As of Aug 11, 2026, the average yearly pay for remote risk adjustment auditor in the United States is $72,633.00, according to ZipRecruiter salary data. Most workers in this role earn between $47,000.00 and $98,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a remote risk adjustment auditor?

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.

More about Remote Risk Adjustment Auditor jobs
What cities are hiring for Remote Risk Adjustment Auditor jobs? Cities with the most Remote Risk Adjustment Auditor job openings:
What are the most commonly searched types of Risk Adjustment Auditor jobs? The most popular types of Risk Adjustment Auditor jobs are:
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What job categories do people searching Remote Risk Adjustment Auditor jobs look for? The top searched job categories for Remote Risk Adjustment Auditor jobs are:
Remote Risk Adjustment Auditor jobs near you
Infographic showing various Remote Risk Adjustment Auditor job openings in the United States as of August 2026, with employment types broken down into 92% Full Time, and 8% Part Time. Highlights an 100% Remote job distribution, with an average salary of $72,633 per year, or $34.9 per hour.

Risk Adjustment Coding Specialist II - Remote

Astrana Health, Inc.

Houston, TX • Remote

$70K - $85K/yr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Description
We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our physician practices remotely!  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!
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
  • Certified Professional Coder (CPC) or CRC from AAPC
  • Certified Risk Adjustment Coder (CRC) certifications from AAPC
  • At least 3 years of experience in risk adjustment experience 
  • At least 1 year experience with provider education 
  • 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 softwares and Electronic Health Records (EHR) systems.
  • Strong knowledge with PowerPoint, preparing presentations, and public speaking
  • Strong experience with Excel - reports, pivot tables, VLOOKUP, etc.
You're great for this role if:
  • Strong billing knowledge and/or Certified Professional Biller (CPB) through AAPC highly preferred
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
  • Experience with multiple EMR/EHR systems
  • Experience with Monday.com and PowerBI
  • Ability to work independently and collaborate in a team setting
  • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting

Environmental Job Requirements and Working Conditions
  • This is a full-time position, operating M-F 830 AM - 5 PM CST. 
  • This is a remote position. The home office is aligned at 1600 Corporate Center Drive, Monterey Park, CA. We are seeking candidates who reside in CST or EST time zones. 
  • 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.
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.