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Work From Home Risk Adjustment Auditor Jobs in Addison, IL

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Work From Home Risk Adjustment Auditor information

See Addison, IL salary details

$30.6K

$72.8K

$117.7K

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 Addison, IL is $72,769.00, according to ZipRecruiter salary data. Most workers in this role earn between $47,100.00 and $98,700.00 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.

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For Work From Home Risk Adjustment Auditor jobs in Addison, IL, the most frequently searched job titles are:

What job categories do people searching Work From Home Risk Adjustment Auditor jobs in Addison, IL look for?

The top searched job categories for Work From Home Risk Adjustment Auditor jobs in Addison, IL are:

Work From Home Risk Adjustment Auditor jobs near you

Coding Investigator Auditor - Work From Home

Health Care Service Corporation

Chicago, IL • Remote

$55K - $123K/yr

Full-time

Medical, Life, Retirement, PTO

Posted 23 days ago

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job SummaryThis position is responsible for auditing clinical, billing, coding and lowest cost setting reviews for services pre and post payment utilizing medical, contractual, legislative, policy, and other information to validate claims submitted and billed. Conducting research. Preparing documentation of findings and consulting with special investigation and the affordability of care area as needed. Coordinating with all departments involved in each case required such as medical director special investigations, customer service, pass, network management, marketing, case management, medical review, legal, pricing and database.

Required Job Qualifications:

  • Bachelor's degree; one year of business experience, law enforcement experience, or regulatory agency experience may substitute for each year of college.
  • Certified Coding Certification, or acquire within 24 months of hire
  • 3 years of experience in claims processing operations and reporting systems, including 2 years of experience in auditing or developing computer system reports.
  • Knowledge of accreditation, i.e. URAC, NCQA standards and health insurance legislation.
  • Awareness of claims processes and claims processing systems.
  • PC proficiency to include Microsoft Word and Excel and health insurance databases.
  • Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings.
  • Organizational skills and prioritization skills

Preferred Job Qualifications:

  • Current AAPC Medical Coding Certification

#LI-MW2

#LI-Remote

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range$55,900.00 - $123,500.00

Exact compensation may vary based on skills, experience, and location.

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