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Trainee Risk Adjustment Auditor Jobs in Georgia (NOW HIRING)

Oscar Health

Auditor, Risk Adjustment

Atlanta, GA · 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 ...

Elevance Health

Coding Auditor Sr. (CareBridge)

Atlanta, GA · On-site

$26.25 - $29.75/hr

Coding Auditor Sr. (CareBridge) Coding Auditor Sr. CareBridge Health is a proud member of the ... Assists with National and Targeted Risk Adjustment Data Validation audits. * Participates and ...

Humana

Medical Coding Educator

Atlanta, GA · On-site

$26.25 - $29.75/hr

Will report to the Manager, Medicare Risk Adjustment. As the Medical Coding Educator 2 you will ... or auditing in a healthcare setting experience * Proficiency with data analytics tools (such as ...

RELX

Senior Data Scientist I

Alpharetta, GA · On-site

$95K - $158K/yr

About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk ... If you have a disability or other need that requires accommodation or adjustment, please let us ...

LexisNexis

Senior Data Scientist I

Alpharetta, GA · On-site

$95K - $158K/yr

About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk ... If you have a disability or other need that requires accommodation or adjustment, please let us ...

Warnerbros

Senior Financial Compliance Analyst

Atlanta, GA · On-site

$82K - $102K/yr

... auditors on various controls and compliance initiatives, as well as business process best-in-class ... Provides support on technical consultation to control and process owners on risk assessment ...

RELX Group plc

Senior Data Scientist I

Alpharetta, GA · On-site

$95K - $158K/yr

About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk ... If you have a disability or other need that requires accommodation or adjustment, please let us ...

Akima, LLC

Property Administrator

Fort Stewart, GA · On-site

$18.25 - $24.50/hr

... prepare adjustment documentation. * Monitor receipt, issue, storage, movement, and disposal of ... Auditing & Reporting: * Prepare and submit required property management reports (e.g., Loss, Damage ...

HANSGROHE

Director, Finance & Accounting

Alpharetta, GA · On-site

$170K - $180K/yr

Maintain an ongoing dialogue with the company's external auditor, senior and subordinate lenders ... Ensure that the company operates sound risk management and internal control systems to safeguard ...

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Trainee Risk Adjustment Auditor information

What is the difference between Trainee Risk Adjustment Auditor vs Risk Adjustment Auditor?

AspectTrainee Risk Adjustment AuditorRisk Adjustment Auditor
CertificationsEntry-level, often requires basic healthcare or auditing certificationsAdvanced certifications like RHIA or RAC are common
Work EnvironmentTraining phase, supervised, learning on the jobFull responsibility, independent audits, detailed analysis
Experience LevelLimited, focused on training and skill developmentExperienced, with proven auditing skills

The Trainee Risk Adjustment Auditor is an entry-level role focused on learning and supporting risk adjustment processes, while the Risk Adjustment Auditor is a fully responsible professional conducting independent audits. The trainee position emphasizes training and supervision, whereas the auditor role requires experience and certification for independent work.

What are the most commonly searched types of Risk Adjustment Auditor jobs in Georgia?

The most popular types of Risk Adjustment Auditor jobs in Georgia are:

What are popular job titles related to Trainee Risk Adjustment Auditor jobs in Georgia?

For Trainee Risk Adjustment Auditor jobs in Georgia, the most frequently searched job titles are:

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The top searched job categories for Trainee Risk Adjustment Auditor jobs in Georgia are:

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Cities in Georgia with the most Trainee Risk Adjustment Auditor job openings:

Trainee Risk Adjustment Auditor jobs near you

Auditor, Risk Adjustment

Oscar Health

Atlanta, GA • Remote

$82K - $108K/yr

Full-time

Re-posted 15 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

255th of 306 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.

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