Remote Risk Adjustment Auditor - Quality & Compliance

name; Arizona; Remote; USD 83,000 - 109,000; Full time

Benefits offered by this job

Unlimited vacation

Annual performance bonuses

Medical, dental, and vision benefits

401(k) plan

Job summary

Oscar Health is seeking an Associate, Risk Adjustment Auditor to support internal and external quality audits focused on ICD-10 code abstraction, accuracy, and documentation improvement opportunities.

The role reports to the Manager, Risk Adjustment and works remotely with candidates in AZ, FL, GA, or TX. Base pay ranges from $82,717 to $108,566 with benefits, unlimited vacation, and annual bonuses.

Qualifications

• Must have ICD-10-CM coding expertise with accuracy and completeness.
• Quality auditing experience and familiarity with RADV projects.
• Experience supporting CMS/HHS audits and documentation.

Responsibilities

• Perform daily operations for Risk Adjustment including medical record reviews and ICD-10-CM coding for ACA and MA lines.
• Validate EDGE data in provider documentation to mitigate risk.
• Monitor coding team performance and report audit trends to leadership.

Skills

ICD-10-CM coding

Quality auditing

CMS/HHS audits

RADV experience

Education

Bachelor's degree or commensurate experience

CPC certification

Job description

Oscar Health is seeking an Associate, Risk Adjustment Auditor to support internal and external quality audits focused on ICD-10 code abstraction, accuracy, and documentation improvement opportunities.

The role reports to the Manager, Risk Adjustment and works remotely with candidates in AZ, FL, GA, or TX. Base pay ranges from $82,717 to $108,566 with benefits, unlimited vacation, and annual bonuses.