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Work From Home Risk Adjustment Auditor Jobs (NOW HIRING)

Humana

Medical Coder

Virginia Beach, VA · On-site +1

$17.75 - $23.75/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Annandale, VA · On-site +1

$18.75 - $24.75/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Winston Salem, NC · On-site +1

$17.25 - $23/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Blythewood, SC · On-site +1

$15 - $20/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Cramerton, NC · On-site +1

$17 - $22.50/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Sevierville, TN · On-site +1

$15.75 - $21.25/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Beaufort, SC · On-site +1

$17 - $22.75/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Bristol, TN · On-site +1

$18.25 - $24.25/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Hendersonville, TN · On-site +1

$17.50 - $23.25/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Burnsville, NC · On-site +1

$16.75 - $22.25/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Lancaster, SC · On-site +1

$16 - $21.25/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Dale City, VA · On-site +1

$21 - $28.25/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

$18.50 - $24.75/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Newport News, VA · On-site +1

$17 - $22.75/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Chattanooga, TN · On-site +1

$17 - $22.75/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Lancaster, VA · On-site +1

$18 - $24.25/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Fuquay Varina, NC · On-site +1

$15.50 - $20.75/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Fuquay Varina, NC · On-site +1

$15.50 - $20.75/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

Humana

Medical Coder

Cookeville, TN · On-site +1

$16 - $21.25/hr

... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ... Medicare Risk Adjustment knowledge Additional Information Work at home - with travel (up to 5%) to ...

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All JobsRisk Adjustment Auditor JobsWork From Home Risk Adjustment Auditor Jobs

Work From Home Risk Adjustment Auditor information

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$30.5K

$72.6K

$117.5K

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

As of Jun 9, 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 are the key skills and qualifications needed to thrive in the Work From Home Risk Adjustment Auditor position, and why are they important?

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 is a Work From Home Risk Adjustment Auditor job?

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.

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Work From Home Risk Adjustment Auditor jobs near you
Sr Analyst, Medical Economics, Stars and Risk Adjustment

Sr Analyst, Medical Economics, Stars and Risk Adjustment

Monogram Health

Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 21 days ago

Job description

Position: Senior Analyst of Medical Economics, Stars and Risk Adjustment
The Senior Analyst of Medical Economics, Stars and Risk Adjustment, will play a key role in advancing Monogram Health's analytical capabilities and driving performance in Star Ratings and Risk Adjustment documentation accuracy. This role will collaborate with key business leaders to create standardized reporting, generate actionable insights and drive strategic initiatives that support performance improvement.
The Senior Analyst partners with internal stakeholders to deliver standardized reporting, identify performance gaps, and support operational improvement initiatives.
Responsibilities
  • Develop and maintain standardized Stars and Risk Adjustment reporting using internal data sources and CMS files within Databricks and Power BI
  • Lead code development and end-user dashboard creation, applying subject-matter expertise to meet defined business needs
  • Serve as a subject matter expert on Risk Adjustment data sources, including MAO-004, 837, MMR, and MOR files
  • Present internal overviews and detailed analytical findings to stakeholders to ensure alignment and clarity on next steps
  • Analyze data to identify trends, performance opportunities and develop actions plans to address gaps
  • Build a deep understanding of clinical workflows and collaborate to enhance processes that support departmental efficiency and effectiveness
  • Partner with internal teams to share insights that may influence underwriting, contracting, operations and other business areas
  • Support the growth of direct and matrixed team members by fostering knowledge-sharing and sustainable progress toward departmental goals

Position Requirements
  • Bachelor's degree required; Master's degree in healthcare or a related field, or actuarial certification (FSA/ASA in progress of completed) preferred
  • Minimum of two (2) years of experience in Medicare Advantage Stars or Risk Adjustment analytics
  • Proficiency in SQL, R, and Python; experience working with large enterprise data warehouses; strong ability to build, modify and optimize data tables; intermediate-to-advanced Power BI skills, including complex DAX and data modeling
  • Knowledge of CMS Risk Adjustment and Stars data sources (MAO-004, 837, MMR, MOR)
  • Ability to translate data into clear, actionable insights
  • Communication skills and ability to collaborate in a matrixed environment and influence others to drive outcomes

Benefits
  • Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
  • Financial & Retirement Support - Competitive compensation, 401k with employer match, and financial wellness resources
  • Time Off & Leave - Paid holidays, flexible vacation time/PSSL, and paid parental leave
  • Wellness & Growth - Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts

About Monogram Health
Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person's health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.
Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient's healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.
Monogram Health's personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.
#LI-AS1
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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