Top 3355 Auditor, risk adjustment Jobs in Texas

Auditor, Risk Adjustment
Oscar Health —Dallas, TX
- $82,717 - $108,566 a year
- Remote
- Mid-level
- Bachelor's degree
- Travel
- Paid parental leave
- Paid holidays
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Risk Adjustment Coder
Suvida Healthcare —Texas
- Full-time
- Remote
- Primary Care
- Mid-level
- 1 year
- Paid parental leave
- Paid holidays
Quick Apply
Auditor, Risk Adjustment Data Validation
University Health —San Antonio, TX
- $22.10 - $38.25 an hour
- Full-time
- Mid-level
- Analysis skills
- Bachelor's degree
- Health insurance
11d
Auditor/Investigator II
Qlarant —Texas
- $57,512 - $85,839 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
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Internal Auditor (contract)
KPMG —Plano, TX
- $50 - $104 an hour
- Contract
- Hybrid work
- Mid-level
- Office
- High school diploma or GED
Clinical Documentation Integrity Auditor
Ascension —Waco, TX
- $96,208.99 - $134,109.89 a year
- Full-time
- Hybrid work
- Mid-level
- High school diploma or GED
- Associate's degree
- Disability insurance
- Health insurance
13d
Internal Auditor II
Jack Henry & Associates —Allen, TX
- $48,350 - $78,000 a year
- Hybrid work
- CPA
- PMP
- Research
4d
HCC Coding Specialist (Temporary, Part Time)
Virtix Health LLC —Texas
- 8 hour shift
- Remote
- Microsoft Outlook
- Mid-level
- Leadership
- Work from home
- Flexible schedule
Quick Apply
5d
Medical Claims Auditor (Remote - Texas)
Gainwell Technologies —Texas
- $50,000 - $55,000 a year
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Continuous improvement
- Travel reimbursement
- Profit sharing
Lead Service Technician
Divcon Controls —Austin, TX
- Full-time
- Ability to walk for extended periods
- Ability to climb stairs
- Ability to lift 50 pounds
- Paid training
- Disability insurance
Quick Apply
6d
Senior Electrical Project Manager - Commercial/Industrial
CS Erickson —Georgetown, TX
- Full-time
- 7 years
- Construction site
- Customer service
Quick Apply
Part Time Public Housing Manager-Mart
Waco Housing Authority & Affiliates —Waco, TX
- $21.50 an hour
- Part-time
- Background check
- Management
- 5 years
- Tuition reimbursement
- Paid time off
Quick Apply
Senior Accountant
Beusa Energy, LLC —The Woodlands, TX
- Overtime
- Background check
- 18 years or older
- Microsoft Excel
Staff Accountant
Extraco Banks, N.A. —Waco, TX
- CPA
- 5 years
- Research
Quick Apply
Facilities Technician 1
Geneva School of Boerne —Boerne, TX
- $18 - $22 an hour
- Full-time
- Microsoft Word
- Background check
- School experience
- Health savings account
- Health insurance
Quick Apply
4d
Lead Service Technician
Divcon Controls —San Antonio, TX
- Full-time
- Ability to walk for extended periods
- Ability to climb stairs
- Ability to lift 50 pounds
- Paid training
- Disability insurance
Quick Apply
6d
Maintenance Technician
PPG —Gainesville, TX
- $24.05 an hour
- Overtime
- Microsoft Word
- Microsoft Excel
- Senior level
Quick Apply
Lead Service Technician
Divcon Controls —Houston, TX
- Full-time
- Ability to walk for extended periods
- Ability to climb stairs
- Ability to lift 50 pounds
- Paid training
- Disability insurance
Quick Apply
6d
Math Campus Instructional Specialist - Secondary
Killeen Independent School District —Killeen, TX
- Full-time
- Classroom
- 5 years
- Writing skills
Quick Apply
Accountant/Payroll
Waco Housing Authority & Affiliates —Waco, TX
- From $24.50 an hour
- Full-time
- Microsoft Excel
- Computer literacy
- English
- Disability insurance
- Health insurance
Quick Apply

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auditor, risk adjustment jobs near texas

Auditor, Risk Adjustment

Oscar Health -
Dallas, TX

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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 texas

Auditor, Risk Adjustment

Risk Adjustment Coder

Auditor, Risk Adjustment Data Validation

Auditor/Investigator II

Internal Auditor (contract)

Clinical Documentation Integrity Auditor

Internal Auditor II

HCC Coding Specialist (Temporary, Part Time)

Medical Claims Auditor (Remote - Texas)

Lead Service Technician

Senior Electrical Project Manager - Commercial/Industrial

Part Time Public Housing Manager-Mart

Senior Accountant

Staff Accountant

Facilities Technician 1

Lead Service Technician

Maintenance Technician

Lead Service Technician

Math Campus Instructional Specialist - Secondary

Accountant/Payroll

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