Risk Adjustment Coder Specialist

1 hour, 41 minutes ago
Full-time
Junior
Operations
Oscar

Oscar

Oscar is a health insurance company that offers plans for individuals, families, and small businesses. With a focus on humanizing health care through technology, design, and data, Oscar provides easy-to-understand bills, 24/7 access to doctors, and a p...

Insurance
1K-5K
Founded 2012

Description

  • Perform daily risk adjustment operations, including medical record reviews to report ICD-10-CM diagnosis codes for ACA and Medicare Advantage lines of business.
  • Support medical record retrieval efforts and respond to potential CMS audits.
  • Maintain compliance with ICD-10-CM coding guidelines, national standards, and risk adjustment production standards.
  • Participate in CMS risk adjustment audits, including Risk Adjustment Data Validation audits.
  • Build relationships with key stakeholders to improve understanding of the risk adjustment process.
  • Identify documentation improvement opportunities to support provider education across MA and ACA lines of business.
  • Identify process improvements to increase the efficiency of medical encounter review.
  • Ensure compliance with all applicable laws and regulations.
  • Perform other duties as assigned.

Requirements

  • Bachelor's degree in a relevant field or equivalent work experience.
  • Certified Professional Coder (CPC) certification.
  • 2+ years of retrospective risk adjustment coding experience.
  • Bonus: Certified Risk Adjustment Coder (CRC) certification or similar.
  • Bonus: Experience coding in multiple Electronic Medical Record (EMR) systems.
  • Must reside in Arizona, Florida, Georgia, or Texas.
  • Remote work from a home office with occasional travel for team meetings and company events.

Benefits

  • Base salary of $67,813 to $89,004 per year.
  • Eligible for annual performance bonuses.
  • Eligible for employee benefits.
  • Unlimited vacation program.
  • Medical, dental, and vision insurance.
  • 11 paid holidays, paid sick time, paid parental leave, and paid wellness time.
  • 401(k) plan participation.
  • Life and disability insurance, plus wellness reimbursements.

Interested in this position?

Apply directly on the company website

Apply Now

Similar Roles

Data Entry Specialist, Remote

ABC Legal Services 251-1K Specialized Consumer Services

ABC Legal Services is hiring a remote e-File Specialist in Kansas to review and file legal documents through internal online systems while supporting the e-Fulfillment and e-Filing team.

11 minutes ago

Senior Propulsion Technician II, Second Shift

Relativity Space 251-1K Aerospace & Defense

Relativity Space is hiring a Senior Propulsion Technician to support fabrication, assembly, and manufacturing scale-up for the Aeon-R engine as part of the Terran R program.

Assembly
11 minutes ago

Mid-Level Auto Body Repair Technician - 2nd Shift -$4,000 Bonus

Carvana 10K-50K Automotive

Carvana is hiring an Experienced Auto Body Repair Technician to perform multi-panel bodywork on vehicles in its inspection centers and help prepare cars for customers.

26 minutes ago

Specialty Pharmacy Technician

Shields Health Solutions 1K-5K Health Care Providers & Services

Shields Health Solutions is hiring a Specialty Pharmacy Technician to support patients and pharmacists in delivering specialty medication management and adherence care.

26 minutes ago

You're on a roll! Sign up now to keep applying.

Sign Up

Already have an account? Log in

Used by 14,729+ remote workers