Associate, Risk Adjustment Auditor (Fully Remote)

• The Associate, Risk Adjustment Auditor conducts internal and external quality audits specific to ICD-10 code abstraction.
• Work with management to implement benchmarks and quality assurance programs.

Responsibilities:

• Perform medical record reviews and report ICD-10-CM diagnosis codes for ACA and MA lines of business.
• Validate EDGE data is supported by provider encounter documentation and report audit trends to leadership.
• Conduct CMS audits and develop clinical documentation improvement resources.

Requirements:

• Bachelor's degree or commensurate work experience.
• Certified Professional Coder (CPC) with 3+ years retrospective risk adjustment coding experience.
• 1+ years quality auditing or RADV experience.
• Medical, dental, and vision benefits.
• Unlimited vacation program and 11 paid holidays.
• Paid parental leave, 401(k) plan, life and disability insurance.

Oscar Health

Oscar is a health insurance company built around a full-stack technology platform and a relentless focus on serving its members. Founded in 2012, it cultivates an inclusive environment where employees can be their authentic selves.