Remote Risk Adjustment Auditor - Quality & Compliance

Oscar Health; Georgia; On-site; USD 82,717 - 108,566; Full time

Benefits offered by this job

Employee benefits

Unlimited vacation program

Annual performance bonuses

Job summary

Oscar Health is hiring a remote Associate, Risk Adjustment Auditor to join their Risk Adjustment team. This role involves conducting internal and external quality audits specific to ICD-10 code accuracy. The ideal candidate will have experience in risk adjustment coding and quality audits, along with a relevant bachelor's degree or certification.

Responsibilities include managing operations related to risk adjustment, maintaining compliance with coding guidelines, and fostering relationships for better understanding of processes.

Qualifications

• 3+ years of retrospective risk adjustment coding experience required.
• 1+ years of Quality Auditing and/or RADV experience needed.
• Bachelor's degree or equivalent work experience expected.

Responsibilities

• Conduct internal and external quality audits on ICD-10 code abstraction.
• Report audit trends to leadership for timely improvements.
• Maintain compliance with national coding standards and practices.

Skills

Risk adjustment coding experience

Quality auditing experience

Knowledge of ICD-10 coding guidelines

Education

Bachelor's degree in a relevant field or commensurate work experience

Certified professional coder (CPC)

Tools

Electronic Medical Record (EMR) systems

Job description

Oscar Health is hiring a remote Associate, Risk Adjustment Auditor to join their Risk Adjustment team. This role involves conducting internal and external quality audits specific to ICD-10 code accuracy. The ideal candidate will have experience in risk adjustment coding and quality audits, along with a relevant bachelor's degree or certification.

Responsibilities include managing operations related to risk adjustment, maintaining compliance with coding guidelines, and fostering relationships for better understanding of processes.