The Judge Group
Eagan, MN
Risk Adjustment Coding Auditor Location: Remote (U.S.) Employment Type: Contract-to-Hire About the Role The Risk Adjustment Coding Auditor is responsible for ensuring the accuracy, completeness, and compliance of diagnosis coding used in risk adjustment programs. This role conducts prospective and retrospective chart audits, validates diagnosis code capture, identifies documentation opportunities, and provides coding guidance to support regulatory compliance and appropriate reimbursement. The auditor serves as a subject matter expert in risk adjustment coding and works closely with internal teams to maintain data integrity and reduce financial and regulatory risk. Key Responsibilities Perform prospective and retrospective medical record reviews and audits. Validate diagnosis code accuracy, completeness, specificity, and appropriateness based on provider documentation. Review medical records to ensure proper capture of CMS-HCC diagnoses and risk adjustment...