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Associate Risk Adjustment Analyst Jobs (NOW HIRING)

Oscar Health

Auditor, Risk Adjustment

Dallas, TX · Remote

$82K - $108K/yr

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 ...

Oscar Health

Auditor, Risk Adjustment

Miami, FL · Remote

$82K - $108K/yr

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 ...

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Associate Risk Adjustment Analyst information

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$29K

$73.7K

$125.5K

How much do associate risk adjustment analyst jobs pay per year?

As of Jun 17, 2026, the average yearly pay for associate risk adjustment analyst in the United States is $73,654.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,000.00 and $81,500.00 per year, depending on experience, location, and employer.

What is the difference between Associate Risk Adjustment Analyst vs Risk Adjustment Analyst?

AspectAssociate Risk Adjustment AnalystRisk Adjustment Analyst
Required CredentialsTypically requires a bachelor's degree, certifications like CPC or RHIA are commonSimilar credentials, often with additional certifications like CRC or RAC
Work EnvironmentHealthcare organizations, insurance companies, consulting firmsSame as Associate Risk Adjustment Analyst, often with more experience
Employer & Industry UsageUsed in health insurance, healthcare analytics, and risk managementSame industry, usually a more experienced role

The main difference between an Associate Risk Adjustment Analyst and a Risk Adjustment Analyst lies in experience and responsibility level. The Associate role is often entry-level or junior, focusing on data collection and basic analysis, while the Risk Adjustment Analyst typically has more experience and handles complex data analysis and reporting tasks.

What are the key skills and qualifications needed to thrive as an Associate Risk Adjustment Analyst, and why are they important?

To thrive as an Associate Risk Adjustment Analyst, you need analytical skills, attention to detail, and a foundational understanding of healthcare data and coding, often supported by a degree in health information management or a related field. Familiarity with risk adjustment software, ICD-10 coding systems, and data analysis tools like Excel or SQL is commonly required. Strong communication, problem-solving abilities, and organizational skills help you collaborate across teams and manage complex data sets. These skills are crucial for accurately evaluating risk, ensuring regulatory compliance, and supporting effective healthcare decision-making.

What are some common challenges faced by Associate Risk Adjustment Analysts when working with healthcare data?

Associate Risk Adjustment Analysts often encounter challenges related to the complexity and variability of healthcare data, such as incomplete patient records, inconsistent coding practices, and evolving regulatory requirements. These factors require strong attention to detail and problem-solving skills to ensure accurate analysis and reporting. Collaborating closely with other teams, such as coding specialists and clinical staff, is essential to clarify data discrepancies and maintain data quality. Staying current with industry updates and adopting best practices can help mitigate these challenges and support effective risk adjustment processes.

What are Associate Risk Adjustment Analysts?

Associate Risk Adjustment Analysts are entry-level professionals who support healthcare organizations in reviewing and analyzing patient data to ensure accurate risk adjustment coding and reporting. Their work helps organizations receive appropriate reimbursement from health plans based on the health status of their patients. These analysts often validate diagnosis codes, identify documentation gaps, and assist in implementing process improvements to optimize risk scores. They typically work under the supervision of senior analysts or managers and may collaborate closely with coding, compliance, and clinical teams.
What states have the most Associate Risk Adjustment Analyst jobs? States with the most job openings for Associate Risk Adjustment Analyst jobs include:
Auditor, Risk Adjustment

Auditor, Risk Adjustment

Oscar Health

Dallas, TX • Remote

$82K - $108K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 18 days ago

Be an early applicant

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

228th of 261 rated insurance

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 (accommodations@hioscar.com) 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.