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Associate, Risk Adjustment Auditor; Fully Remote

Remote / Online - Candidates ideally in
Charlotte, Mecklenburg County, North Carolina, 28245, USA
Listing for: Oscar Health
Remote/Work from Home position
Listed on 2026-10-03
Job specializations:
  • Quality Assurance - QA/QC
Salary/Wage Range or Industry Benchmark: 75000 - 105000 USD Yearly USD 75000.00 105000.00 YEAR
Job Description & How to Apply Below
Position: 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.

Position Requirements
10+ Years work experience
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