• Risk Adjustment Clinical

    UPMC (Pittsburgh, PA)
    UPMC Health Plan has an exciting opportunity for a Risk Adjustment Clinical Auditor /Analyst position in the Medicare department. This is a full time ... hours and will be fully remote.. The Clinical Auditor /Analyst is an integral part of the Risk Adjustment Department and is responsible for reviewing and… more
    UPMC (09/30/25)
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  • Auditor , HCC Risk Adjustment

    Datavant (Harrisburg, PA)
    …educational and life experiences to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical records ... using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical… more
    Datavant (08/08/25)
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  • Coding Data Quality Auditor

    CVS Health (Harrisburg, PA)
    …to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical ... to such evidence across stakeholders with varying knowledge and clinical expertise in either written or verbal forms including...anatomy for all body systems.-Understand the audit process for risk adjustment models. + Identify and communicate… more
    CVS Health (10/16/25)
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  • Staff Coding Compliance Auditor (medical…

    Geisinger (Danville, PA)
    …Minimum one Coding Certification required:--Certified Professional Coder - AAPC --Certified Risk Adjustment Coder - American Academy of Professional Coders ... Job Summary The Compliance Auditor position is responsible for supporting the organization's...Technician (RHIT) - American Health Information Management Association; Certified Risk Adjustment Coder - American Academy of… more
    Geisinger (10/18/25)
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  • Coding Auditor & Educator

    WelbeHealth (Harrisburg, PA)
    …education and experience in coding and auditing + Minimum of two (2) years of Risk Adjustment (HCC) coding experience in a managed care environment + Current ... At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate...on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as… more
    WelbeHealth (09/19/25)
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