Oscar Health
Risk Adjustment Auditor
$83K–$109K
Florida, United States +1 · Full-time · Posted Sep 29, 2026
- Location
- Florida, United States
New York, United States - Experience
- 3+ year(s) retrospective risk adjustment coding experience; 1+ year(s) Quality Auditing and/or RADV experience.
- Education
- Bachelor's degree in a relevant field of study or commensurate work experience.
About the job
Conducts quality audits of risk adjustment coding and medical records to assess ICD-10-CM accuracy, completeness, and clinical documentation improvement opportunities.
What you'll do
- Review medical records and report ICD-10-CM diagnosis codes for ACA and MA lines of business; support audits and record retrieval.
- Audit coding team performance, validate documentation support for EDGE data, and report trends to leadership.
- Conduct CMS and RADV audits and develop provider education and process improvements.
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
Model-written summary · the original posting is authoritative