Risk Adjustment Auditor - ICD-10 & RADV Quality
Oscar Health
Oscar Health is seeking an Associate, Risk Adjustment Auditor to conduct internal and external quality audits of ICD-10 code abstraction and collaborate with management on benchmarks and quality assurance programs. Responsibilities include medical record reviews, reporting ICD-10-CM codes for ACA and MA lines, validating EDGE data, reporting audit trends, CMS audits, and developing clinical documentation improvement resources. #J-18808-Ljbffr Oscar Health
- 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... ...experience. 1+ years quality auditing or RADV experience. Medical, dental, and vision benefits...QualityRiskRemote jobWork experience placement
$82.72k - $108.57k
Oscar Health is hiring an Associate, Risk Adjustment Auditor to conduct internal and external quality audits focused on ICD-10 code abstraction and accuracy. You will work with management to set benchmarks, thresholds, and QA programs, reporting to the Manager, Risk Adjustment...QualityRiskRemote job- 1099 HCC Risk Adjustment & Professional-Fee (Physician) Coder... ...Adjustment and Professional-Fee Auditor 1099 hourly Pinnacle... ...code(s) (CPT/HCPCS, ICD, Modifier).... ...daily production goal and quality goal of averaging 95% accuracy... ...Ability to code ICD-10, modifier and CPT/HCPCS...QualityRiskHourly payPart timeRemote workWork from homeFlexible hours
- ...StatesCompany: AAPCPosted: 2026-10-06Coding... ...improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses... ...Inpatient coding by assigning ICD-CM and ICD-PCS codes as well... ...assignment and sequencing of risk adjustment diagnoses following...QualityRiskWork at officeLocal areaRemote work
- CVS Health is seeking a detail‑oriented reviewer to perform quality audits of medical records coded for CMS risk adjustment. You will support ICD coding accuracy, mentor staff, and lead dispute resolution across teams to ensure regulatory compliance. The role emphasizes...QualityRiskFull time
$134.6k - $230.8k
...seeking an Executive Director of Risk Adjustment join our team in New York, NY... ...Ensure adherence to ICD-10, CMS-HCC, and state-specific... ...compliance and legal on audits, RADV readiness, and corrective actions... ...processes Coordinate with Quality teams to align provider touchpoints...QualityRiskMinimum wageFull timeWork experience placementLocal areaWork from home$33.88 - $42.35 per hour
...assesses, monitors and documents ICD-10 diagnoses based coding... ...in and supports the Medicare Risk Adjustment team-based environment to educate... ...a model of care focused on quality and health outcomes. Works internally... ...Adjustment Data Validation (RADV) related projects and...QualityRiskContract workWork experience placementFlexible hours- ...StatesCompany: AAPCPosted: 2026-10-03DaMar Staffing is seeking an experienced Quality Assurance Auditor with a coding background. The... ...provider education and risk mitigation initiatives.Location... ...coding, 3+ years in HCC/risk adjustment, 2+ years auditing/QA, and active...QualityRiskRemote work
- ...Performance Bonus Job Overview: A Certified Risk Adjustment Coder works to improve the quality of coding documentation and data in the HCC database.... ...use and application of coding classification such as ICD-10-CM. Essential Functions : Review medical record...QualityRiskFlexible hours
- Location: New York, United StatesCompany: Accenture PLCPosted: 2026-10-07Accenture is seeking a Risk and Compliance Specialist focusing on Internal Audit Quality Assurance. You will work within the Risk and Compliance vertical to perform compliance reviews, publish actionable...QualityRisk
- ...StatesCompany: ADP, Inc.Posted: 2026-10-07The Senior Risk Adjustment Coder is responsible for accurate and... ...coding accuracy, and compliance with CMS, ICD-10-CM, and organizational... ...improve coding accuracy, documentation quality, and program performanceServe as subject...QualityRiskWork at officeRemote work
- Location: New York, United StatesCompany: AAPCPosted: 2026-10-02PathWell Home Health is seeking a Home Health... ...with clinical staff to improve documentation quality and reduce claim denials.The role requires ICD-10 expertise, OASIS knowledge, and proficiency with EMR...QualityRemote workFlexible hours
- ...supplemental medical records to assign supported ICD-10-CM diagnosis codes and applicable... ...role requires advanced proficiency in risk adjustment coding platforms, electronic medical... ...care compliance, health care operations (quality, risk, etc.), audit, finance, regulatory...QualityRiskWork experience placement
- ...records, identify diagnoses, and code them according to ICD-10-CM guidelines to support risk adjustment and payer reimbursement. Ideal candidates have at... ...independently in a remote setting while delivering high-quality, accurate coding for multiple client projects. #J-18...QualityRiskRemote job
$25 - $26.7 per hour
...representation of patient conditions for risk adjustment and reimbursement purposes. You will... ...will ensure compliance with established ICD-10 CM, DRGs coding guidelines, third party... ...production environment while maintaining high quality. Must be able to follow instructions,...QualityRiskRemote workFlexible hours- ...allocation, performance management, quality review, and professional... ...development Key Requirements ~10+ years of experience in... ..., Regulatory Examination, Risk Management, or a related function... ...technical analytics findings for auditors, management, and non-technical...QualityRiskFull time
$102k - $203k
Senior Vice President, Auditor, Credit Risk At BNY, our culture allows us to run our company better and enables employees’ growth... ...Supervision and Regulation Letters (e.g. SR 11-10)Experience drafting high-quality audit issues (issue articulation, impact, root cause,...QualityRiskTemporary workWork at officeWorldwideFlexible hours$95k - $110k
...sustainable supply of quality products emerges from the... ...Summary The Internal Auditor supports AdvanSix's independent... ...leading and executing risk-based audits, SOX... ...plant locations and HQ (10 to15%), as needed... ...include periodic pay rate adjustments based on market competitiveness...QualityRiskTemporary workWork experience placementFlexible hours- ...an outpatient Certified Coding Auditor to work in its New York office... ...to identify areas of risk in a variety of healthcare settings... ...auditing (E&M, CPT, HCPCS, and ICD-10), with knowledge of professional... ...(CPMA) Certified Risk Adjustment Coder (CRC™) Certified Coding...RiskWork at officeLocal areaRemote work
$115k - $150k
...Hybrid Travel Required 10% Relocation Assistance Available... ...delivering both independent, risk-based, and objective assurance... ..., and effectively.As Lead Auditor - Data & AI, you will deliver... ...support audit conclusions and meet quality standards.Stay updated on data...QualityRiskFull timeTemporary workWork at officeLocal areaRelocation package3 days per week$96.8k - $137k
...Global Audit team as a Senior Internal Auditor providing independent assurance and risk management oversight across our... ...with audit programs and quality standards, while providing on-the-... ...calendar year). Paid sick leave is adjusted based on role and location in accordance...QualityRiskHourly payLocal areaWorldwideRelocation$96.8k - $137k
...Senior Auditor Established in 1806 as a small soap and candle business... ...will continue to improve the quality of life for our consumers... ...providing independent assurance and risk management oversight across... ...year). Paid sick leave is adjusted based on role and location in...QualityRiskHourly payLocal areaWorldwide$100k - $120k
...Sr. Auditor Sompo has a unique opportunity for a Sr. Auditor to... ...a broad range of operations, risks, and senior stakeholders.... ...professional standards to deliver high-quality, consistent audit outcomes.... ...and incentives that gets adjusted upfront based on overall Company...QualityRiskFull timeWork at officeFlexible hours- ...Description Job Title - Senior IT Auditor Location - 405 Lexington... ...and analyze processes, risk and control matrices supporting... ...financial reporting and produce high-quality SOX narratives Perform IT... ...audit a plus ~ Ability to travel 5-10% per year...QualityRisk
- ...Active certification — at least one of CCDS, CHC, CCS, or CPC ICD-10 coding experience Currently working in medical coding,... ...CDIP, or similar) Familiarity with Epic Experience with HCC or risk-adjustment coding Prior AI/ML annotation or model evaluation work experience...RiskPart timeWork experience placementRemote work10 hours per weekFlexible hours
- ...Senior Risk Consultant Counterparty Credit Risk (SR 11-10) · Risk Transformation Program About the role Arrayo builds and embeds senior delivery... ...and land change across functions. Produce senior-quality written deliverables — assessments, target-state designs...QualityRiskFull timeShift work
$108k - $208.8k
...businesses, technologies, data, and risks to connect the dots on complex... ...experienced Senior Compliance Auditor to contribute to the ongoing... ...LIVE, TikTok Shop etc.). - Quality Assurance: Ensure the overall... ...others. Employees also receive 10 paid holidays per year, 10...QualityRiskTemporary workLocal area$58.7k - $70.4k
Remote The Risk Adjustment Coding Analyst provides operational, analytical, and administrative support... ...to improve manual work, strengthen data quality, enhance partner usability, and improve... ...speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable...QualityRiskFull timeWork at officeRemote workWork from homeHome office$31 per hour
...global freelance AI services provider focusing on data annotation and quality assurance, seeks a freelance pilot in the United States. You will... ...patterns, and articulate actionable feedback to raters. Start ASAP; 10 hours per week; pay is $31/hour. #J-18808-Ljbffr Welo DataQualityFreelanceImmediate start10 hours per week- Norwood in the United States is seeking a Risk Adjustment professional to join our team. You will review Medicare/Medicare Advantage HCC coding, perform retrospective audits of encounters, and ensure accurate risk adjustment documentation. Proficiency in Excel is essential...RiskRemote jobPermanent employmentFull time
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