Risk Adjustment Auditor II
Portland, Oregon - Added Dec 20th, 2025
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Risk Adjustment Auditor II – Healthcare Industry!
Our client, a leading healthcare organization dedicated to improving member and provider experiences, is seeking a Risk Adjustment Auditor II to support accurate, compliant risk adjustment reporting through retrospective and prospective chart reviews. This role plays a critical part in validating diagnosis code accuracy, identifying provider documentation trends, and supporting quality improvement initiatives across the risk adjustment program.
The ideal candidate brings deep expertise in risk adjustment coding, strong analytical skills, and the ability to collaborate closely with provider education and clinical partners to drive accurate documentation and reporting.
Type: Contract Only – Duration 16 weeks
Work Model: 100% Remote (Within the 48 states)
Responsibilities of the Risk Adjustment Auditor II:
Required Certifications (Both Required):
Qualifications of the Risk Adjustment Auditor II:
**We are unable to accommodate corp. to corp. candidates**
About Motus Recruiting and Staffing, Inc:
Founded in 2006, Motus is an award-winning recruiting and staffing firm in the Pacific Northwest, specializing in professional services and technology solutions. We are a group of people who not only recognize the importance of representation, but actively fight for diversity, equity, and inclusion in the recruitment process. Our goal is to educate organizations on the importance of DEI when hiring, promoting, and supporting diverse employees. We are calling organizations to demonstrate their commitment to DEI by being intentional about who they hire. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability or protected veteran status.
KG/BH13654
Our client, a leading healthcare organization dedicated to improving member and provider experiences, is seeking a Risk Adjustment Auditor II to support accurate, compliant risk adjustment reporting through retrospective and prospective chart reviews. This role plays a critical part in validating diagnosis code accuracy, identifying provider documentation trends, and supporting quality improvement initiatives across the risk adjustment program.
The ideal candidate brings deep expertise in risk adjustment coding, strong analytical skills, and the ability to collaborate closely with provider education and clinical partners to drive accurate documentation and reporting.
Type: Contract Only – Duration 16 weeks
Work Model: 100% Remote (Within the 48 states)
- Candidates must be willing and able to work Pacific Time Zone hours
- Occasional overtime or weekend work may be required.
Responsibilities of the Risk Adjustment Auditor II:
- Perform retrospective and prospective chart reviews, both onsite (as applicable) and remotely, to ensure accurate risk adjustment reporting
- Verify the accuracy, completeness, specificity, and appropriateness of provider-reported diagnosis codes based on medical record documentation
- Review medical records to ensure complete diagnosis code capture aligned with CMS HCC categories
- Identify trends in provider coding and documentation and collaborate with Provider Education Consultants to develop targeted intervention strategies
- Support and actively participate in process improvement and quality initiatives
- Maintain current knowledge of regulatory mandates and ensure compliance with all applicable requirements
- Meet departmental productivity, quality, and attendance standards consistently
- Serve as a mentor and subject matter resource to Risk Adjustment Auditor I staff
- Assist with special projects, including risk mitigation reviews
- Monitor and interpret regulatory changes impacting risk adjustment programs and support implementation efforts as needed
Required Certifications (Both Required):
- CRC – Certified Risk Adjustment Coder
- CPC – Certified Professional Coder
Qualifications of the Risk Adjustment Auditor II:
- Associate degree in Healthcare or a related field preferred
- 5–7 years of experience in clinical coding, auditing, or an equivalent combination of education and experience
- Demonstrated ability to perform accurate and complete chart reviews for risk adjustment
- Advanced knowledge of risk adjustment, diagnosis coding, and documentation requirements
- Strong working knowledge of ICD-9-CM and ICD-10 Coding Guidelines
- Experience identifying and communicating trends in provider coding and documentation
- Strong analytical and problem-solving skills with the ability to implement solutions efficiently
- Proficiency with Microsoft Office (Word, Excel, Outlook) and general PC skills
- Strong written and verbal communication skills
- Knowledge of health system operations, reimbursement methodologies, and coding conventions for governmental and commercial products
- Ability to provide proactive and creative solutions to complex business problems
**We are unable to accommodate corp. to corp. candidates**
About Motus Recruiting and Staffing, Inc:
Founded in 2006, Motus is an award-winning recruiting and staffing firm in the Pacific Northwest, specializing in professional services and technology solutions. We are a group of people who not only recognize the importance of representation, but actively fight for diversity, equity, and inclusion in the recruitment process. Our goal is to educate organizations on the importance of DEI when hiring, promoting, and supporting diverse employees. We are calling organizations to demonstrate their commitment to DEI by being intentional about who they hire. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability or protected veteran status.
KG/BH13654
Job ID: 13654
