Associate, Risk Adjustment Auditor — Remote

Job overview

The Associate, Risk Adjustment Auditor role is remote for candidates residing in Arizona, Florida, Georgia, or Texas; the listing identifies Dallas, TX, and occasional travel may be required for team meetings and company events. Base pay is $82,717–$108,566 per year. The role reports to the Manager, Risk Adjustment at Oscar Health, a health insurer focused on serving its members through a technology platform. The auditor conducts quality reviews of diagnosis-code abstraction and clinical documentation to support accurate risk adjustment and compliance. By identifying audit trends, supporting provider education, and helping implement process improvements, the role contributes to reliable coding and risk-adjustment operations.

What you'll do

• Conduct medical-record reviews and report ICD-10-CM diagnosis codes for ACA and Medicare Advantage lines of business
• support potential CMS and HHS audits and medical-record retrieval
• validate that EDGE data is supported by provider encounter documentation
• review Risk Adjustment Coding team performance and report audit trends
• maintain compliance with ICD-10-CM coding guidelines and production standards
• conduct Risk Adjustment Data Validation audits
• build relationships to improve understanding of risk adjustment
• create clinical documentation improvement resources for provider education
• manage process improvements.

What we're looking for

Skills & competencies

associate risk adjustment auditor

remote

arizona

florida

georgia

texas

oscar health

$82,717–$108,566 per year

icd-10-cm

risk adjustment

medical record audits

certified professional coder

provider education

occasional travel

Work arrangement

• Weekend coverage required

Benefits & perks

• Medical, dental and vision benefits
• unlimited vacation program
• annual performance bonuses
• 11 paid holidays
• paid sick time
• paid parental leave
• 401(k)
• life and disability insurance
• paid wellness time and reimbursements.

Why this role

Remote within Arizona, Florida, Georgia, or Texas. Requires a Certified Professional Coder credential, three or more years of retrospective risk-adjustment coding experience, and one or more years of quality auditing or RADV experience.

About the employer

Oscar Health is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.