Risk Adjustment Auditor

Job overview

The Risk Adjustment Auditor role is remote for candidates residing in Arizona, Florida, Georgia, or Texas. Compensation is $82,717–$108,566 per year. The role joins Oscar Health’s Risk Adjustment team, reporting to the Manager, Risk Adjustment. The auditor reviews medical records and coding quality to support accurate risk adjustment, regulatory compliance, and documentation improvement. The role helps identify trends, strengthen coding practices, and improve provider education and risk-adjustment processes.

What you'll do

• Conduct internal and external quality audits of ICD-10-CM code abstraction
• review medical records for ACA and Medicare Advantage lines of business
• validate encounter data against provider documentation
• report audit trends to leadership
• maintain coding and production standards
• conduct CMS risk-adjustment audits
• develop provider documentation-improvement resources
• support process improvements and regulatory compliance.

What we're looking for

Skills & competencies

risk adjustment auditor

remote

arizona

florida

georgia

texas

oscar health

icd-10-cm

medical record audits

risk adjustment

$82,717–$108,566/year

provider education

occasional travel

Work arrangement

• Weekend coverage required

Benefits & perks

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

Why this role

Remote work is limited to residents of Arizona, Florida, Georgia, or Texas; occasional travel may be required for team meetings and company events.

About the employer

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