Oscar Health
Risk Adjustment Auditor
$83K–$109K
Arizona, United States +1 · Full-time · Posted Sep 29, 2026
- Location
- Arizona, United States
New York, United States - Experience
- 3+ years of retrospective risk adjustment coding; 1+ year of Quality Auditing and/or RADV audit experience.
- Education
- Bachelor's degree in a relevant field of study or commensurate work experience.
About the job
Conducts risk adjustment coding and quality audits, validating medical documentation and ICD-10-CM codes while identifying trends and improvements.
What you'll do
- Review medical records and report ICD-10-CM diagnosis codes; support audit and record-retrieval activities.
- Audit risk adjustment coding and documentation, validate EDGE data, and report trends to leadership.
- Develop provider education resources and implement process improvements and quality assurance programs.
What they ask for
- Bachelor's degree in a relevant field of study or commensurate work experience.
- Certified professional coder (CPC).
- 3+ year(s) retrospective risk adjustment coding experience.
- 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV) experience.
Nice to have
- Certified Risk Adjustment Coder (CRC) or similar certification.
- Experience coding in a variety of different Electronic Medical Record (EMR) systems.
Pay
USD 82,717 - USD 108,566 per year (base salary)
Tools
ICD-10-CM, EDGE, Electronic Medical Record (EMR) systems
Model-written summary · the original posting is authoritative