Remote Risk Adjustment Auditor - Quality & Coding

Namely; Town of Florida (NY); Remote; USD 83,000 - 109,000; Full time

Benefits offered by this job

Health benefits

Unlimited vacation

Annual performance bonuses

Job summary

Oscar Health seeks an Associate, Risk Adjustment Auditor to conduct quality audits of ICD-10 code abstraction and identify documentation improvement opportunities. You will work with management to set benchmarks, thresholds, and QA programs, reporting to the Manager, Risk Adjustment.

This remote role welcomes candidates in AZ, FL, GA, or TX, with occasional travel for meetings and events. Base pay ranges from $82,717 to $108,566 per year, with benefits and bonuses.

Qualifications

• Bachelor's degree or commensurate work experience.
• Certified professional coder (CPC).
• 3+ years retrospective risk adjustment coding experience.
• 1+ year RADV experience.

Responsibilities

• Daily operations for Risk Adjustment including medical record reviews and report ICD-10-CM codes.
• Mitigate risk by validating EDGE data against provider documentation.
• Review coding team performance and report audit trends to leadership.
• Maintain ICD-10-CM coding guideline compliance and risk adjustment standards.
• Conduct CMS audits of Risk Adjustment activities and data validation.

Skills

CPC

Risk Adjustment

Quality Auditing

Education

Bachelor's degree or commensurate

Job description

Oscar Health seeks an Associate, Risk Adjustment Auditor to conduct quality audits of ICD-10 code abstraction and identify documentation improvement opportunities. You will work with management to set benchmarks, thresholds, and QA programs, reporting to the Manager, Risk Adjustment.

This remote role welcomes candidates in AZ, FL, GA, or TX, with occasional travel for meetings and events. Base pay ranges from $82,717 to $108,566 per year, with benefits and bonuses.