Risk Adjustment Coding Auditor

St. Louis, MO, US • Posted 1 day ago • Updated 4 hours ago
Full Time
On-site
USD $32.00 - 37.00 per hour
Fitment

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Job Details

Skills

  • Finance
  • Data Integrity
  • Decision-making
  • HIPAA
  • Privacy
  • Reporting
  • Documentation
  • Medical Records
  • Regulatory Compliance
  • Health Insurance
  • Durable Skills
  • Military
  • Auditing
  • Medicare
  • AutoCAD Architecture
  • Medicaid
  • HEDIS
  • Natural Language Processing
  • Marketing Operations
  • Taxes
  • Life Insurance
  • Partnership
  • Collaboration
  • Business Transformation
  • Law
  • Sourcing
  • Screening
  • Recruiting
  • Artificial Intelligence

Summary

Job Description
The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise.
Your Responsibilities
  • Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices
  • Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements
  • Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting
  • Verifies and ensures the accuracy, completeness, specificity and appropriateness of provider-reported diagnosis codes based on medical record documentation
  • Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories
  • Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with requirements
  • Provide written and verbal guidance on coding errors to others
  • Meets audit deliverables within established timelines and deadlines

Skills
Audit, CRC, Coding, Risk Adjustment, Health Insurance
Qualifications
Required skills and experiences
  • 7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
  • 5+ years of HCC coding experience in utilizing inpatient and outpatient coding guidelines
  • 5+ years of experience auditing Risk Adjustment records
  • CRC (Certified Risk Coder) in good standing
  • Intermediate level of knowledge in risk adjustment Medicare, ACA Commercial and Medicaid models

Preferred skills and experiences (NOT REQUIRED)
  • Bachelor's degree
  • HEDIS/STARS experience
  • Provider education experience
  • Prior RADV experience
  • CPMA or other coding credentials
  • NLP Software experience
Job Type & Location
This is a Contract position based out of St. Louis, MO.
Pay and Benefits
The pay range for this position is $32.00 - $37.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Aug 11, 2026.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: 101054TS
  • Position Id: JP-006184823
  • Posted 1 day ago
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