Associate, Risk Adjustment Auditor

Location: Remote within the United States, limited to candidates residing in Arizona, Florida, Georgia, or Texas; occasional travel may be required for team meetings and company events.

Salary: $82,717–$108,566 per year, plus annual performance bonuses.

Company

hirify.global is a health insurance company built around a full-stack technology platform and member-focused healthcare services.

What you will do

• Conduct internal and external quality audits of ICD-10-CM code abstraction, medical records, and clinical documentation.
• Review medical records for ACA and Medicare Advantage risk adjustment coding and support potential CMS and HHS audits.
• Validate that EDGE data is supported by provider encounter documentation.
• Analyze Risk Adjustment Coding team performance and report audit trends to leadership.
• Develop clinical documentation improvement resources and provider education for MA and ACA lines of business.
• Implement process improvements that maximize risk adjustment factor increases while maintaining regulatory compliance.

Requirements

• Bachelor's degree in a relevant field or equivalent work experience.
• Certified Professional Coder (CPC) certification.
• At least 3 years of retrospective risk adjustment coding experience.
• At least 1 year of quality auditing and/or Risk Adjustment Data Validation (RADV) audit experience.
• Compliance with ICD-10-CM coding guidelines, production standards, and applicable laws and regulations.

Nice to have

• Certified Risk Adjustment Coder (CRC) or similar certification.
• Experience coding in multiple electronic medical record systems.

Culture & Benefits

• Remote work from an approved U.S. state with occasional travel for team meetings and company events.
• Unlimited vacation program and 11 paid holidays.
• Medical, dental, and vision benefits.
• Paid sick time, paid parental leave, wellness time and reimbursements.
• 401(k) participation, life insurance, and disability insurance.
• Inclusive environment focused on belonging, support, and equal opportunity.