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Work From Home Risk Adjustment Auditor Jobs (NOW HIRING)

Centene

Risk Adjustment Auditor Educator

$56K - $101K/yr

Work in conjunction with other departments to include Provider Relations, Quality as well as the ... Works on additional risk adjustment audit requests (i.e. outside auditors' requests). * Serves on ...

ClinDCast LLC

Risk Adjustment Coding Auditor

Albany, NY · Remote

$30 - $35/hr

We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...

ClinDCast LLC

Risk Adjustment Coding Auditor

Albany, NY · Remote

$27 - $30.75/hr

We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...

ClinDCast LLC

Risk Adjustment Coding Auditor

Albany, NY · Remote

$27 - $30.75/hr

We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...

Datavant

Auditor, HCC Risk Adjustment Coding

$28 - $31.75/hr

... work. What You Will Do: * Audit coded charts assigned by quality supervisor per the client ... Ability to move from different sets of client guidelines with minimal difficulty * Maintain a 95 ...

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How much do work from home risk adjustment auditor jobs pay per year?

As of Sep 3, 2026, the average yearly pay for work from home 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 is a work from home risk adjustment auditor?

A Work From Home Risk Adjustment Auditor is responsible for reviewing medical records to ensure accurate coding and documentation for risk adjustment purposes. They assess diagnoses, procedures, and services to verify that they align with coding guidelines and regulatory requirements. This role helps healthcare organizations optimize reimbursement and maintain compliance with coding standards. Working remotely, auditors use electronic health records and coding software to perform their duties efficiently. Strong attention to detail, coding certification (such as CRC, CPC, or CCS), and knowledge of risk adjustment models are essential for success in this role.

What are the typical daily responsibilities of a work from home risk adjustment auditor?

As a Work From Home Risk Adjustment Auditor, your typical day involves reviewing medical records to identify and validate diagnosis codes, ensuring compliance with Medicare, Medicaid, or commercial risk adjustment guidelines. You will often manage a queue of charts, utilize specialized auditing software, and document your findings clearly for reporting purposes. Communication with team members or supervisors is usually conducted via phone, email, or secure messaging platforms. This role may also require you to participate in quality assurance reviews, training sessions, and periodic team meetings to stay updated on coding standards and audit protocols.

What are the key skills and qualifications needed to thrive in the work from home risk adjustment auditor position?

To thrive as a Work From Home Risk Adjustment Auditor, you need a strong understanding of medical coding (especially ICD-10-CM), healthcare compliance, and medical record review, often supported by credentials such as CPC or CRC certification. Familiarity with electronic medical records (EMR) systems, health plan software, and auditing platforms is essential. Excellent attention to detail, organizational skills, and the ability to work independently make candidates stand out in this remote position. These skills ensure accurate risk adjustment data, regulatory compliance, and reliable performance while collaborating virtually with healthcare teams.

What cities are hiring for Work From Home Risk Adjustment Auditor jobs?

Cities with the most Work From Home Risk Adjustment Auditor job openings:

What states have the most Work From Home Risk Adjustment Auditor jobs?

States with the most job openings for Work From Home Risk Adjustment Auditor jobs include:

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Work From Home Risk Adjustment Auditor jobs near you
Infographic showing various Work From Home Risk Adjustment Auditor job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $72,633 per year, or $34.9 per hour.

Risk Adjustment Auditor Educator

Centene

Remote

$56K - $101K/yr

Full-time

Medical, Retirement, PTO

Posted 15 days ago

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 406 frontline employees who took The Breakroom Quiz

12th of 898 rated healthcare providers

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Conduct provider medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of care. Analysis of MRA data to identify patterns and development of interventions at the provider and market level.

  • Subject matter experts for proper risk adjustment coding and CMS data validation
  • Work in conjunction with other departments to include Provider Relations, Quality as well as the Medical Director for the state assigned to ensure compliance of CMS risk adjustments guidelines are met.
  • Analyze MRA data to identify patterns and development of interventions at the provider and market level to coordinate an educational work plan for WellCare contracted providers.
  • Conduct provider education and training regarding risk adjustment to help to ensure accurate CMS payment and to improve quality of care.
  • This includes training venues such as provider offices, hospitals, webinars, conference calls, email correspondence, etc.
  • Works on additional risk adjustment audit requests (i.e. outside auditors' requests).
  • Serves on the RADV Committee as subject matter experts.
  • Perform quality assurance auditing (i.e. ensure appropriateness and accuracy of ICD-9/ICD-10 coding) for WellCare's Medical Coding Specialists.
  • Communicates QA results to the Medical Coding Specialists with suggestions for improvement and re-training topics.
  • Perform other duties as necessary.
  • Complies with all policies and standards

Education/Experience: Bachelor's degree or equivalent experience required

Candidate Experience: 5+ years of experience in a hospital, a physician setting or a Managed Care Organization as a medical coder
2+ years of experience in coding with knowledge of Medicare risk adjustment (HCC Coding)
Required Other experience in teaching, training or an educator/instructor role required; but provider education experience is preferred
Preferred Other managed care experience
Licenses and Certifications: A license in one of the following is required:
One of the following licensures required at hire: CPC or CCS
CRC required within the 1st year of employment
CPMA preferred on the 2nd year of employment

Pay Range: $56,200.00 - $101,000.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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