[Hiring] Risk Adjustment Compliance Auditor @Alignment Health

Role Description

Alignment Health is seeking a remote Risk Adjustment Compliance Auditor to support auditing and compliance activities related to risk adjustment data submitted to CMS. In this role, you will:

• Conduct provider and coder-level audits.
• Review medical record documentation and coding accuracy.
• Identify compliance risks and outliers.
• Support RADV and other risk adjustment audit initiatives.

This position is ideal for an experienced certified coder with a strong understanding of risk adjustment, HCC coding, compliance auditing, and CMS guidelines within a health plan, IPA, or managed care environment. You will partner closely with Risk Adjustment leadership and cross-functional teams to help ensure:

• Coding accuracy.
• Regulatory compliance.
• Audit readiness.
• Corrective action follow-through across the organization.

The role combines auditing, documentation review, reporting, compliance monitoring, and collaborative problem-solving in a fully remote environment. You will also help provide audit feedback and compliance education to internal and provider-facing stakeholders as needed.

Schedule:

• Full-time, Monday – Friday
• Initial training schedule will align primarily with Pacific Time business hours
• Flexible working hours available post-training based on business needs and team collaboration

Qualifications

• Minimum 3 years of professional coding experience in a medical group or health plan setting.
• Bachelor’s degree in business administration, health care management or in a related field or 4 years additional experience in lieu of education.
• Certified Coder required - CPC, CCS & CCS-P.

Requirements

• Experience with strategic planning in risk mitigation.
• Previous use of Epic, Allscripts, EZCap a plus.
• Proficient user in MS office suite, MS access a plus.
• Ability to communicate positively, professionally and effectively with others.
• Effective written and oral communication skills.
• Ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors.
• Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly.
• Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving.
• Problem-Solving Skills: Effective problem solving, organizational and time management skills.
• Report Analysis Skills: Comprehend and analyze statistical reports.

Benefits

• Pay Range: $64,384.00 - $96,577.00.
• Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Company Description

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first.

We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.