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Senior Risk Adjustment Auditor Jobs in Virginia (NOW HIRING)

Senior IT Internal Auditor

Richmond, VA ยท Hybrid

$83K - $103K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

The Senior IT Internal Auditor supports the organization's Sarbanes-Oxley (SOX) compliance program and contributes to risk-based internal audit and advisory engagements. This role is responsible for ...

Sr Internal Auditor - Technology

Richmond, VA

$83K - $103K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

English (Required) Work Shift: 1st shift (United States of America) Please review the following Truist Senior Internal Auditor is responsible for assisting in the completion and documentation of risk ...

Senior Professional Coder

Broadway, VA ยท Remote

$64K - $97K/yr

Act as an expert for the HCC/Risk adjustment coding. This position is remote but does require ... auditing) to ensure documentation and selection of HCC diagnosis codes meet the requirements set ...

Senior IT Auditor

Blacksburg, VA ยท On-site

$82K - $108K/yr

Senior IT Auditor Apply now Back to search results Job no: 537365 Work type: Administrative ... Enterprise Risk & Integrity Location: Blacksburg, Virginia Categories: Legal / Compliance, Other ...

Senior IT Auditor

Mclean, VA ยท On-site

$95K - $124K/yr

Senior IT Auditor Responsibilities include conducting reviews of general support system controls ... risk/impacts in order to take the appropriate course of action to eliminate or manage the ...

Senior Internal Auditor - (Herndon, VA *Hybrid)

Herndon, VA ยท On-site

$86K - $108K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

As a senior internal auditor you will be the day-to-day/on the ground leader for the audit ... Perform audits of contracts with customers or Serco business units to cover areas based on a risk ...

IT Auditor

Richmond, VA ยท On-site

Sr. IT Auditor 12 months contract with high potential to extend and convert Hybrid in Richmond, VA Role Overview: We are seeking a skilled Auditor to execute risk-based audits of IT, operational ...

IT Auditor

Richmond, VA ยท On-site

Sr. IT Auditor 12 months contract with high potential to extend and convert Hybrid in Richmond, VA Role Overview: We are seeking a skilled Auditor to execute risk-based audits of IT, operational ...

Showing results 41-60

Senior Risk Adjustment Auditor information

What is a senior risk adjustment auditor?

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.

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

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.

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 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:

Senior IT Internal Auditor

Hamilton

Richmond, VA โ€ข Hybrid

$83K - $103K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 19 days ago


Job description

We're looking for a Senior IT Internal Auditor.


The Senior IT Internal Auditor supports the organization's Sarbanes-Oxley (SOX) compliance program and contributes to risk-based internal audit and advisory engagements. This role is responsible for executing audit procedures, including walkthroughs and testing of control design and operating effectiveness, with a primary focus on IT General Controls (ITGCs), automated controls, and IT-dependent controls.


The Senior IT Internal Auditor performs audit procedures with moderate supervision and contributes to the delivery of high-quality audit and advisory engagements.


The position requires close collaboration with control owners, IT teams, and external auditors to ensure timely and high-quality audit execution. The IT Internal Auditor also contributes to broader internal audit initiatives by identifying risks, evaluating control environments, and providing recommendations to enhance operational effectiveness and compliance. This position is a hybrid role requiring three days in the home office based in Richmond, VA. The Senior IT Internal Auditor reports to the IT Internal Audit Manager based in Richmond, VA.


What you will do


Role and Responsibilities


  • Participate inthe planning, execution, and completion of risk-based internal IT audits covering infrastructure, applications, cybersecurity, data governance, technology operations, business continuity processes, and ITenabled business areas.
  • Perform design and operating effectiveness testing of IT general controls, including ITGCs, automated controls, and key reports/IT-dependent controls.
  • Participate in the annual risk assessment of IT audit topics and support the development of the annual IT audit plan.
  • Work collaboratively with colleagues at all levels to understand, plan, and perform IT audits and tests of controls.
  • Work collaboratively with external auditors, including supporting reliance activities and coordinating testing efforts.
  • Perform specialprojects,as assigned.
  • Demonstrate sound judgment, maintain confidentiality, and handle sensitive information appropriately.

Conduct Standards


  • You must act with integrity
  • You must act with due skill, care and diligence
  • You must be open and cooperative with the CBI, FCA, the PRA and other regulators
  • You must pay due regard to the interests of customers and treat them fairly
  • You must observe proper standards of market conduct
  • You must act to deliver good outcomes for retail customers


What you require for the role


Preferred Skills


  • Experience in public accounting (assurance or advisory), with Big Four or a reputable regional firm, preferred.
  • Proficiencyin Microsoft Office suite.
  • Strongwritten and verbal communication skills.
  • Ability to work independently while contributing effectively within a team environment.
  • Curiosity and passion for understanding emerging technology, cyber, and AIrelated risks.
  • Experience with information systems auditing, SOX compliance, and internal controls frameworks.
  • Strong analytical, organizational, and problem-solving skills with attention to detail.
  • Knowledge ofgenerally acceptedaccounting principles(GAAP), the IIA International Professional Practices Framework (IPPF), COSO's Internal Control - Integrated Framework, preferred.

Qualifications


  • Bachelor's degree in accounting, Finance, Information Systems, ora relatedfield.
  • Minimum of 4+ years of relevant experience in IT audit, internal audit, or information systems control environments.
  • Professional certifications are preferred (one or more):
    • Certified Information Systems Auditor (CISA)
    • Certified Internal Auditor (CIA)
    • Certified Public Accountant (CPA)

What you can expect from us


At Hamilton, we offer a vibrant, entrepreneurial and collaborative workplace shaped by our values: Be Smart, Be Sensible, Be Open and Be More.


Our employees consistently say they would recommend Hamilton as a great place to work - a testament to the inclusive, supportive, and empowering culture we've built together. We embrace individuality, value diverse perspectives, and recognise the unique contribution each person makes to our continued success.


Hamilton offers a competitive salary with an annual performance-based target bonus and a comprehensive benefits package, to include:

  • Hybrid working
  • Matching 401K plan
  • Medical, dental, vision, life, disability
  • Generous time off (including parental leave)
  • Continued support for professional development
  • Gym subsidy
  • My day (additional days leave for personal interests/wellness/charity work


In good company.

Hamilton (NYSE: HG) underwrites specialty insurance and reinsurance risks on a global basis through its wholly owned subsidiaries. Its three underwriting platforms: Hamilton Global Specialty, Hamilton Select and Hamilton Re, each with dedicated and experienced leadership, provide access to diversified and profitable business around the world.

Headquartered in Bermuda, Hamilton has over 600 employees with key underwriting operations in London, Bermuda, the US and Dublin. We work collaboratively, we share a passion for the service and results we deliver, and we know that what we do each day is meaningful - to our customers and our business. We believe we are 'In good company.' with everyone we interact with.