Remote Risk Adjustment Auditor – Quality & Compliance

Oscar Health; Georgia; Remote; USD 83,000 - 109,000; Full time

Benefits offered by this job

Unlimited vacation

Annual bonuses

Benefits package

Job summary

Oscar Health is seeking an Associate, Risk Adjustment Auditor to join the Risk Adjustment team. You will conduct internal and external quality audits focused on ICD-10 code abstraction and opportunities for documentation improvement.

This remote role welcomes candidates in AZ, FL, GA, or TX. Base pay ranges from $82,717 to $108,566 annually, with benefits, unlimited vacation, and annual bonuses.

Qualifications

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

Responsibilities

• Perform daily Risk Adjustment operations including medical record reviews and reporting ICD-10-CM codes for ACA and MA lines.
• Validate EDGE data aligns with provider documentation to mitigate risk.
• Monitor audit trends and communicate findings to Leadership for corrective actions.

Skills

Risk Adjustment Coding

Quality Auditing

Education

Bachelor's degree

Job description

Oscar Health is seeking an Associate, Risk Adjustment Auditor to join the Risk Adjustment team. You will conduct internal and external quality audits focused on ICD-10 code abstraction and opportunities for documentation improvement.

This remote role welcomes candidates in AZ, FL, GA, or TX. Base pay ranges from $82,717 to $108,566 annually, with benefits, unlimited vacation, and annual bonuses.