Risk Management Analyst

Finding a job that fits your lifestyle isn’t always easy. That’s where Kelly® Professional & Industrial comes in. Kelly is seeking a Risk Adjustment Coding Auditor to support a Leading Healthcare client in Eagan, MN.

Snapshot:

Location: Eagan, MN

Pay Rate: Starts at $35.00/HR

Position Type: Contract – 11/16/26 to 4/2/27 with potential for conversion

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.

Requirements

• 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
• Contributes to audit and productions efforts to meet business demand and workload priorities
• Provide written and verbal guidance on coding errors to others
• Meets audit deliverables within established timelines and deadlines
• Assists with special projects such as risk mitigation reviews
• Serves as subject matter resource regarding the risk adjustment process and diagnosis coding for risk adjustment

Required Skills:

• 7+ years of related professional experience. All relevant experience including work, education, transferable skills and military experience will be considered
• Candidates must demonstrate basic proficiency in Microsoft 365, including the ability to use Outlook and Teams for meeting scheduling, calendar management and day-to-day collaboration
• 5+ years of HCC coding experience in utilizing inpatient and outpatient coding guidelines
• 5_ years of experience auditing Risk Adjustment records
• 1+ years working in a Production environment
• CRC in good standing, in addition to required coding certification or ability to obtain certification with the first 6 months of hire, upon possible conversion
• Intermediate level of knowledge in risk adjustment Medicare, ACA Commercial and Medicaid models
• Demonstrated ability to apply critical thinking skills to coding policy interpretation and implementation
• Experience providing written and verbal guidance on coding errors and trends
• Intermediate (or higher) MS Office (Word, Excel, Powerpoint and Outlook)
• Excellent organizational ability to manage multiple projects and perform in a deadline driven environment
• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills:

• Bachelor’s degree
• HEDIS/STARS experience
• Provider education experience
• Prior RADV experience
• CPMA or other coding credentials

What’s Next?:

Once you apply, you’ll proceed to the next steps if your skills and experience look like a good fit. But don’t worry - even if this position doesn’t work out, you’re still in our network. That means all our recruiters will have access to your profile, expanding your opportunities even more. Helping you discover what’s next in your career is what we’re all about, so let’s get to work.

If you have these qualifications, apply today!

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