Top 34 Coding quality auditor Jobs in Miami Fl

Auditor, Risk Adjustment
Oscar Health —Miami, FL
- $82,717 - $108,566 a year
- Remote
- Mid-level
- Bachelor's degree
- Travel
- Paid parental leave
- Paid holidays
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Professional Fee Coding Auditor
Pediatric Associates —Plantation, FL
- Full-time
- Remote
- HIPAA
- 3 years
- Pediatrics
9d
Director - Clinical Documentation Integrity - FT - Days - MTC
Memorial Healthcare System —Miramar, FL
- Full-time
- RN License
- 5 years
- High school diploma or GED
Coder I - Billing & Audit - FT - Days - MSS - Hybrid Eligible
Memorial Healthcare System —Miramar, FL
- Full-time
- Hybrid work
- Anatomy knowledge
- Customer service
- Mid-level
Medical Coding Auditor CPC Primary Care & Gynecology
All inclusive preventive care —Miami Gardens, FL
- Part-time
- Hybrid work
- Primary Care
- Mid-level
- 3 years
- Work from home
- Flexible schedule
Quick Apply
12d
Hospital Based Outpatient Coder II - HIM - FT - Days - MSS - Remote Eligible
Memorial Healthcare System —Miramar, FL
- Full-time
- Remote
- Anatomy knowledge
- Surgery
- Customer service
Sr Compliance Auditor
Nicklaus Children's Hospital —Miami, FL
- 7 years
- Research
- Analysis skills
Audit Analyst - Audit Department
US DEFAULT GROUP INC —Plantation, FL
- Full-time
- Mid-level
- Finance
- Bachelor's degree
- Paid holidays
- Health insurance
Controller
Skin Laundry —Miami, FL
- $120,000 - $140,000 a year
- Remote
- Microsoft Excel
- CPA
- Bachelor of Science
Quick Apply
Medical Review Nurse - CMS RAC (Government audits)
Performant Financial Corporation —Plantation, FL
- $81,000 - $90,000 a year
- Full-time
- Remote
- RN License
- Computer literacy
- Writing skills
- Health savings account
- Paid holidays
Physician Practice E&M Auditor Educator, MCVI Administration
Baptist Health South Florida —Coral Gables, FL
- $26.13 - $33.97 an hour
- Customer service
- Research
- Mid-level
- Wellness program
- Health insurance
Medical Review Clinical Appeals Auditor (RN)
Performant Financial Corporation —Plantation, FL
- $80,000 - $90,000 a year
- Full-time
- Microsoft Excel
- RN License
- Computer literacy
- Health savings account
- Paid holidays
Manager, Revenue Cycle Management
Centrum Health —Doral, FL
- Microsoft Word
- Microsoft Outlook
- 5 years
Quick Apply
2d
Inpatient Clinical Documentation Integrity Manager - FT - Days - MSS
Memorial Healthcare System —Miramar, FL
- Full-time
- Acute care
- Nursing
- RN License
Senior Financial Controller
The Pharmacy Hub —Fort Lauderdale, FL
- $135,000 - $155,000 a year
- Background check
- CPA
- Office
- Health insurance
- Dental insurance
Quick Apply

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Auditor, Risk Adjustment

Oscar Health -
Miami, FL

Quick Apply

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

coding quality auditor jobs in miami fl

Auditor, Risk Adjustment

Professional Fee Coding Auditor

Director - Clinical Documentation Integrity - FT - Days - MTC

Coder I - Billing & Audit - FT - Days - MSS - Hybrid Eligible

Medical Coding Auditor CPC Primary Care & Gynecology

Hospital Based Outpatient Coder II - HIM - FT - Days - MSS - Remote Eligible

Sr Compliance Auditor

Audit Analyst - Audit Department

Controller

Medical Review Nurse - CMS RAC (Government audits)

Physician Practice E&M Auditor Educator, MCVI Administration

Medical Review Clinical Appeals Auditor (RN)

Manager, Revenue Cycle Management

Inpatient Clinical Documentation Integrity Manager - FT - Days - MSS

Senior Financial Controller

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