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Senior Risk Adjustment Auditor Jobs in Washington

SC&H Group

Risk Senior Manager

Columbia, MD · On-site +1

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 ...

SC&H Group

Risk Senior Manager

Columbia, MD · On-site

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 ...

SC&H Group

Risk Senior Manager

Tysons Corner, VA · On-site

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 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 Washington?

The most popular types of Risk Adjustment Auditor jobs in Washington are:

What are popular job titles related to Senior Risk Adjustment Auditor jobs in Washington?

For Senior Risk Adjustment Auditor jobs in Washington, the most frequently searched job titles are:

What job categories do people searching Senior Risk Adjustment Auditor jobs in Washington look for?

The top searched job categories for Senior Risk Adjustment Auditor jobs in Washington are:

What cities in Washington are hiring for Senior Risk Adjustment Auditor jobs?

Cities in Washington with the most Senior Risk Adjustment Auditor job openings:

Senior Risk Adjustment Auditor jobs near you
Infographic showing various Senior Risk Adjustment Auditor job openings in Washington as of July 2026, with employment types broken down into 100% Full Time. Highlights an 68% In-person, 9% Hybrid, and 23% Remote job distribution.

Remote Risk Adjustment Coder - Tier 3

The CSI Companies

Washington, DC • On-site

Other

Medical, Dental, Vision, Life

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

Job description

CSI Companies is partnering with a leading healthcare technology and value-based care organization to hire a Senior Risk Adjustment Coder. This role is designed for highly experienced risk adjustment professionals who can independently review complex records, maintain exceptional coding quality, and contribute to overall documentation and coding accuracy initiatives.Hours: Full-Time (40 hours/week) or Part-Time (20+ hours/week) available
Location: 100% Remote
Pay: Competitive hourly rate based on experience, education, and credentials
Position Type: 6-Month Contract with Strong Conversion Potential for top performers
Start Date: Immediate Need What You'll Do:

  • Conduct advanced retrospective reviews for risk adjustment and HCC capture
  • Review highly complex clinical documentation and assign accurate ICD-10-CM codes
  • Ensure coding practices align with CMS, client, and regulatory standards
  • Identify documentation gaps and coding opportunities
  • Maintain productivity standards of 4-10 charts per hour based on chart complexity
  • Consistently achieve and maintain 95% or greater quality accuracy
  • Participate in coding quality audits and escalation reviews
  • Provide guidance and support to junior coders when appropriate
  • Assist in calibrations, education sessions, and coding best practice discussions
  • Serve as a subject matter expert for risk adjustment coding initiatives
  • Other duties as assigned
What We're Looking For:
  • Active CPC-A, CCA, CPC, CCS, CRC, RHIT, or RHIA credential
  • 5+ years of dedicated Risk Adjustment/HCC coding experience is required
  • Expert-level ICD-10-CM coding knowledge
  • Strong understanding of CMS-HCC and Medicare Advantage risk adjustment methodologies
  • Experience reviewing complex specialty and chronic condition documentation
  • Proven history of meeting productivity and quality expectations
  • Ability to work independently with minimal oversight
  • Available to start immediately
Nice to Have:
  • Multiple coding certifications
  • Experience performing coding audits or quality reviews
  • Experience mentoring or training coders
  • Medicare Advantage, ACO, Value-Based Care, or Population Health experience
Who Should Apply? This position is ideal for seasoned Risk Adjustment coders who thrive in a high-performance environment. You are comfortable navigating complex medical records, consistently producing high-quality work, and helping drive accurate risk adjustment outcomes across large member populations. For consideration, please submit your resume highlighting your Risk Adjustment and ICD-10 coding experience. Only candidates selected for interviews will be contacted. Benefits Offered:
  • Weekly Pay
  • Medical, Dental, and Vision Coverage
  • Voluntary Life and AD&D Coverage
  • Fully Remote Flexibility
  • Opportunity for Permanent Employment Based on Performance and Business Need
  • Flexible Scheduling with Part-Time and Full-Time Options Available

About Us
The CSI Companies is a leading staffing and recruiting firm, providing healthcare organizations with highly skilled professionals since 1994. We have been recognized as a "Best of Staffing" award winner for over a decade, and we pride ourselves on delivering exceptional talent to leading healthcare organizations. #VMSUL

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