Remote Risk Adjustment Auditor - Quality & Compliance

Oscar Health; Dallas (TX); On-site; USD 82,717 - 108,566; Full time

Benefits offered by this job

Participation in unlimited vacation program

Annual performance bonuses

Medical, dental, and vision benefits

401(k) plan participation

Paid parental leave

Job summary

Oscar Health is hiring an Associate, Risk Adjustment Auditor for their Risk Adjustment team. This remote role focuses on conducting quality audits related to ICD-10 code accuracy and completeness. You will engage in audit operations and compliance, while working with the management team to enhance quality assurance programs.

Required qualifications include a Bachelor's degree or equivalent experience, a CPC certification, and at least 3 years of risk adjustment coding experience. The position offers competitive pay and a robust benefits package.

Qualifications

• Bachelor's degree in a relevant field of study or commensurate work experience.
• Certified professional coder (CPC).
• 3+ years retrospective risk adjustment coding experience.
• 1+ year experience in Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV).

Responsibilities

• Conduct internal and external quality audits related to ICD-10 code abstraction.
• Responsible for daily operations pertaining to Risk Adjustment.
• Review the performance of the Risk Adjustment Coding team.
• Conduct CMS audits of Risk Adjustment activities.
• Identify and execute on the creation of clinical document improvement resources.

Skills

Retrospective risk adjustment coding

Quality Auditing

ICD-10 coding

Education

Bachelor's degree or commensurate work experience

Certified professional coder (CPC)

Tools

Electronic Medical Record systems

Job description

Oscar Health is hiring an Associate, Risk Adjustment Auditor for their Risk Adjustment team. This remote role focuses on conducting quality audits related to ICD-10 code accuracy and completeness. You will engage in audit operations and compliance, while working with the management team to enhance quality assurance programs.

Required qualifications include a Bachelor's degree or equivalent experience, a CPC certification, and at least 3 years of risk adjustment coding experience. The position offers competitive pay and a robust benefits package.