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Senior Risk Adjustment Auditor Jobs in Virginia (NOW HIRING)

Senior Auditor - Risk Management Capital One's Audit function is a dedicated group of professionals focused on delivering top-quality assurance services to the organization's Audit Committee. Audit ...

Senior Auditor - Risk Management

Mclean, VA

$81K - $100K/yr

Senior Auditor - Risk Management Capital One's Audit function is a dedicated group of professionals focused on delivering top-quality assurance services to the organization's Audit Committee. Audit ...

Senior Auditor - Risk Management Capital One's Audit function is a dedicated group of professionals focused on delivering top-quality assurance services to the organization's Audit Committee. Audit ...

Senior Auditor - Risk Management

Mclean, VA

$81K - $100K/yr

Senior Auditor - Risk Management Capital One's Audit function is a dedicated group of professionals focused on delivering top-quality assurance services to the organization's Audit Committee. Audit ...

Senior Auditor - Risk Management

Mclean, VA · On-site

$81K - $100K/yr

Senior Auditor - Risk Management Capital One's Audit function is a dedicated group of professionals focused on delivering top-quality assurance services to the organization's Audit Committee. Audit ...

Senior Auditor - Risk Management

Mclean, VA · On-site

$81K - $100K/yr

Senior Auditor - Risk Management Capital One's Audit function is a dedicated group of professionals focused on delivering top-quality assurance services to the organization's Audit Committee. Audit ...

SC&H's Risk Practice is seeking a Senior Manager to lead and grow our service line with a strong ... Experience coordinating with external auditors and working in regulated industries (SaaS, fintech ...

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Senior Risk Adjustment Auditor information

What are Senior Risk Adjustment Auditors?

Senior Risk Adjustment Auditors are experienced professionals who review medical records and data to ensure accurate coding and documentation for risk adjustment purposes, primarily in healthcare settings. They help organizations comply with government regulations and maximize appropriate reimbursement by identifying and correcting coding errors or gaps. Their role involves analyzing patient data, collaborating with coding teams, and providing feedback or training to improve documentation practices. Senior auditors often have advanced knowledge of ICD-10-CM coding, risk adjustment models (such as HCC), and auditing standards. Their expertise helps healthcare organizations maintain compliance and optimize financial performance.

How does a Senior Risk Adjustment Auditor typically collaborate with coding teams and healthcare providers to ensure accurate documentation and coding?

A Senior Risk Adjustment Auditor often works closely with medical coding teams and healthcare providers to review patient records for accuracy and compliance with risk adjustment guidelines. This collaboration may involve providing feedback on documentation quality, clarifying coding ambiguities, and offering training or guidance on best practices. Regular meetings and audits help ensure that everyone is aligned with current regulations and organizational standards. Effective communication and teamwork are essential to maintain high-quality, compliant coding that supports proper reimbursement and patient care.

What are the key skills and qualifications needed to thrive as a Senior Risk Adjustment Auditor, and why are they important?

To thrive as a Senior Risk Adjustment Auditor, you need deep expertise in medical coding (ICD-10-CM), risk adjustment methodologies, and a background in healthcare compliance, typically supported by certifications such as CRC, CPC, or CCS-P. Familiarity with auditing platforms, data analysis tools, and electronic medical records systems is crucial. Exceptional attention to detail, analytical thinking, and strong communication skills help auditors identify discrepancies and effectively collaborate with providers. These competencies ensure accurate risk scoring, regulatory compliance, and optimal reimbursement for healthcare organizations.

What is the difference between Senior Risk Adjustment Auditor vs Risk Adjustment Auditor?

AspectSenior Risk Adjustment AuditorRisk Adjustment Auditor
CertificationsCPMA, RAC, or similarCPMA, RAC, or similar
Work EnvironmentHealthcare organizations, insurance companies, consulting firmsHealthcare providers, insurance companies, auditing firms
Job ResponsibilitiesLeading audits, mentoring, complex data analysisPerforming audits, data review, compliance checks

Both roles require similar certifications and work in healthcare or insurance settings. The Senior Risk Adjustment Auditor typically handles more complex audits, provides mentorship, and takes on leadership tasks, whereas the Risk Adjustment Auditor focuses on executing audits and data analysis. The senior role involves greater responsibility and expertise, often leading to career advancement in risk adjustment auditing.

What are the most commonly searched types of Risk Adjustment Auditor jobs in Virginia? The most popular types of Risk Adjustment Auditor jobs in Virginia are:
What are popular job titles related to Senior Risk Adjustment Auditor jobs in Virginia? For Senior Risk Adjustment Auditor jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Senior Risk Adjustment Auditor jobs in Virginia look for? The top searched job categories for Senior Risk Adjustment Auditor jobs in Virginia are:
What cities in Virginia are hiring for Senior Risk Adjustment Auditor jobs? Cities in Virginia with the most Senior Risk Adjustment Auditor job openings:
Sr. Risk Manager for Enterprise Program Governance

Sr. Risk Manager for Enterprise Program Governance

Capital One

Richmond, VA

Full-time

Posted yesterday


Capital One rating

7.7

Company rating: 7.7 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

91st of 170 rated banks


Job description

Sr. Risk Manager for Enterprise Program Governance

Capital One's Enterprise Risk Management (ERM) Team has responsibility for helping the overall organization identify, manage, and mitigate key risks that may keep the company from achieving its strategic objectives. ERM is currently seeking a Senior (Sr) Risk Manager who will be responsible for managing implementation and enhancement projects for a diverse set of initiatives, with a broad range of complexity and scale.

This Sr. Risk Manager role will require excellent communication and interpersonal skills, a passion for quality assurance, strong attention to detail and a desire to help the enterprise appropriately manage the change risk associated with large-scale project execution. In addition, very strong communication and partnership skills are essential for engaging with key stakeholders to manage, inform, and influence outcomes.

Specific responsibilities include, but are not limited to, the following:

  • Lead Standard Adherence activities for large programs - document outputs, and communicate results with program leaders and stakeholders

  • Perform effective challenge over large programs with strong critical thinking and negotiation skills, challenging assumptions about project health and timelines

  • Lead program Governance Evaluations - document outputs and communicate results with program leaders and stakeholders

  • Lead documentation requests with audit and/or external regulators on matters related to change governance

  • Identify the root causes of recurring project failures across the enterprise to determine if issues come from poor planning, lack of resources, or weak governance

  • Streamline and modernize the change governance framework by leveraging automation and AI tools to reduce administrative burden and speed up risk identification

  • Partner cross-functionally in larger efforts, to provide strategic and tactical thought partnership to effectively drive project delivery

  • Building relationships and collaborating with key stakeholders to ensure delivery of commitments

  • Drive continuous improvements to the ERM program to increase operational efficiency, reduce execution risk, and make board reporting more impactful

  • Bring clarity to ambiguous situations, analyze incomplete project data, isolate the true risk factors, and recommend clear next steps

Basic Qualifications:

  • Bachelor's Degree or military experience

  • At least 4 years of process management, risk management, audit or change management experience

  • At least 3 years of project management experience

  • At least 3 years of experience in modernizing governance frameworks, including streamlining workflows and adopting digital tools or AI to improve risk oversight.

  • At least 2 years of experience using project management tools (Risks, Assumptions, Issues, and Dependencies (RAID), Waterfall, Agile)

  • At least 2 years of experience using Google or Microsoft Office Suite

Preferred Qualifications :

  • Project Management Professional (PMP) certification, Scrum Master certification, Lean Six Sigma certification or Internal Auditor certification

  • 2+ years of experience in the financial industry

  • 2+ years of experience in consulting industry

At this time, Capital One will not sponsor a new applicant for employment authorization for this position.

The minimum and maximum full-time annual salaries for this role are listed below, by location. Please note that this salary information is solely for candidates hired to perform work within one of these locations, and refers to the amount Capital One is willing to pay at the time of this posting. Salaries for part-time roles will be prorated based upon the agreed upon number of hours to be regularly worked.

Chicago, IL: $161,500 - $184,300 for Sr. Risk Manager


McLean, VA: $177,700 - $202,800 for Sr. Risk Manager


Richmond, VA: $161,500 - $184,300 for Sr. Risk Manager


Riverwoods, IL: $161,500 - $184,300 for Sr. Risk Manager








Candidates hired to work in other locations will be subject to the pay range associated with that location, and the actual annualized salary amount offered to any candidate at the time of hire will be reflected solely in the candidate's offer letter.

This role is also eligible to earn performance based incentive compensation, which may include cash bonus(es) and/or long term incentives (LTI). Incentives could be discretionary or non discretionary depending on the plan.

Capital One offers a comprehensive, competitive, and inclusive set of health, financial and other benefits that support your total well-being. Learn more at theCapital One Careers website. Eligibility varies based on full or part-time status, exempt or non-exempt status, and management level.

This role is expected to accept applications for a minimum of 5 business days.No agencies please. Capital One is an equal opportunity employer (EOE, including disability/vet) committed to non-discrimination in compliance with applicable federal, state, and local laws. Capital One promotes a drug-free workplace. Capital One will consider for employment qualified applicants with a criminal history in a manner consistent with the requirements of applicable laws regarding criminal background inquiries, including, to the extent applicable, Article 23-A of the New York Correction Law; San Francisco, California Police Code Article 49, Sections 4901-4920; New York City's Fair Chance Act; Philadelphia's Fair Criminal Records Screening Act; and other applicable federal, state, and local laws and regulations regarding criminal background inquiries.

If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation, please contact Capital One Recruiting at 1-800-304-9102 or via email at RecruitingAccommodation@capitalone.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodations.

For technical support or questions about Capital One's recruiting process, please send an email to Careers@capitalone.com

Capital One does not provide, endorse nor guarantee and is not liable for third-party products, services, educational tools or other information available through this site.

Capital One Financial is made up of several different entities. Please note that any position posted in Canada is for Capital One Canada, any position posted in the United Kingdom is for Capital One Europe and any position posted in the Philippines is for Capital One Philippines Service Corp. (COPSSC).


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