Top 842 Auditor, risk adjustment Jobs in Smyrna Ga

Auditor, Risk Adjustment
Oscar Health —Atlanta, GA
- $82,717 - $108,566 a year
- Remote
- Mid-level
- Bachelor's degree
- Travel
- Paid parental leave
- Paid holidays
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Sr. Auditor/Risk Consultant
Northside Hospital Inc. —Atlanta, GA
- Full-time
- CPA
- Word processing
- Research
Inventory Auditor
Costco Wholesale Corporation —Atlanta, GA
- Research
- Mid-level
- Driving
- AD&D insurance
- Employee stock purchase plan
Staff Auditor
Holder Construction —Vinings, GA
- Full-time
- Background check
- Construction site
- Office
- Health insurance
- Dental insurance
10d
Accounts Receivable / Contract Auditor
Budget Rent a Car of Atlanta —Marietta, GA
- Contract
- Research
- High school diploma or GED
- Organizational skills
13d
Audit Leadership Development Program (ALA) Auditor
UPS —Atlanta, GA
- Hybrid work
- CPA
- Mid-level
- Office
Senior Internal Auditor
Kennesaw State University —Kennesaw, GA
- $86,400 - $96,000 a year
- Full-time
- Background check
- CPA
- Pass drug screening
- Paid holidays
- Health insurance
5d
Commercial Graduate-Atlanta
Sage —Atlanta, GA
- Online Application
- Hybrid work
- Office
- Analysis skills
- Continuous improvement
- Paid parental leave
- Health insurance
Therapist
Tailoriste Consultants —Atlanta, GA
- $32.50 - $40.00 an hour
- Contract
- Background check
- 6 years
- Addiction Medicine
Quick Apply
Sales Excellence Graduate-Atlanta
Sage —Atlanta, GA
- Online Application
- Hybrid work
- Office
- US work authorization
- Communication skills
- Paid parental leave
- Health insurance
Medical Coding Auditor
IN Compass Health —Alpharetta, GA
- Full-time
- 5 years
- Acute care experience
- In-person
- Health insurance
- Dental insurance
Quick Apply
Upperline Health Nurse Practitioner Opportunity Austell, GA | Value Based Medicine Sign on Bonus Available
Upperline PC —Austell, GA
- Full-time
- Nursing
- Management
- RN License
- Mileage reimbursement
- Health insurance
Quick Apply
Psychologist
Software Technology Inc —Smyrna, GA
- Experience working with individuals with disabilities
- Mid-level
- Psychology
Quick Apply
TIG Welder - Day Shift
Chart, Inc. —Canton, GA
- Overtime
- Mid-level
- High school diploma or GED
- Ability to lift 50 pounds
Quick Apply
Accounting Coordinator
IMBERA USA LLC —Kennesaw, GA
- Full-time
- Spanish
- Oracle
- CPA
- Disability insurance
- Relocation assistance
Quick Apply
3d
Financial Advisor
Sourced. —Atlanta, GA
- $61,742.05 - $74,356.02 a year
- Weekends as needed
- 7 years
- Office
- Finance
- Health insurance
- Dental insurance
Quick Apply
FBI Special Agent: CPA/Accounting/Finance Expertise
Federal Bureau of Investigation —Atlanta, GA
- $103,263 - $133,200 a year
- Full-time
- Doctoral degree
- CPA
- Master's degree
Senior Technical Specialist, General Liability
Travelers —Alpharetta, GA
- $94,400 - $155,800 a year
- Research
- High school diploma or GED
- Analysis skills
- Wellness program
- Continuing education credits
Assistant Corporate Controller
Vaco by Highspring —Roswell, GA
- $200,000 - $250,000 a year
- CPA
- Office
- Finance
- Health insurance
- Dental insurance
Quick Apply
Staff Accountant
Sourced. —Atlanta, GA
- $76,000 - $100,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Mid-level
- Office
- Disability insurance
- Health insurance
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auditor, risk adjustment jobs near smyrna ga

Auditor, Risk Adjustment

Oscar Health -
Atlanta, GA

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Job Details

$82,717 - $108,566 a year

Benefits

Paid parental leave
Paid holidays
Disability insurance
Health insurance
Dental insurance
Parental leave
Vision insurance
Paid sick time

Qualifications

Certified Professional Coder

Full Job Description

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Associate, Risk Adjustment Auditor conducts internal and external quality audits. Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and identified clinical documentation improvement opportunities. You will work with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs.

You will report into the Manager, Risk Adjustment.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities:

Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts.
Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation
Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented.
Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards.
Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits.
Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process.
Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business.
Manage the implementation process improvements that will maximize risk adjustment factor increases.
Compliance with all applicable laws and regulations
Other duties as assigned

Requirements:

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

Bonus points:

Certified Risk Adjustment Coder (CRC) or similar certification
Experience coding in a variety of different Electronic Medical Record (EMR) systems.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care - an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([email protected]) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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Refine Your Search

auditor, risk adjustment jobs in smyrna ga

Auditor, Risk Adjustment

Sr. Auditor/Risk Consultant

Inventory Auditor

Staff Auditor

Accounts Receivable / Contract Auditor

Audit Leadership Development Program (ALA) Auditor

Senior Internal Auditor

Commercial Graduate-Atlanta

Therapist

Sales Excellence Graduate-Atlanta

Medical Coding Auditor

Upperline Health Nurse Practitioner Opportunity Austell, GA | Value Based Medicine Sign on Bonus Available

Psychologist

TIG Welder - Day Shift

Accounting Coordinator

Financial Advisor

FBI Special Agent: CPA/Accounting/Finance Expertise

Senior Technical Specialist, General Liability

Assistant Corporate Controller

Staff Accountant

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