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Full-Time

Senior Specialist

Risk Adjustment Coder

Posted on 7/9/2024

Oscar Health

Oscar Health

1,001-5,000 employees

Health insurance with personalized, affordable care

Data & Analytics

Compensation Overview

$65.5k - $95.5kAnnually

+ Performance Bonuses

Junior

Remote in USA

Category
Diagnostics & Laboratory Professionals
Healthcare Administration & Support
Medical, Clinical & Veterinary
Requirements
  • Bachelor’s degree in a relevant field of study or commensurate work experience
  • Certified professional coder (CPC)
  • 2+ year(s) retrospective risk adjustment coding experience
Responsibilities
  • Responsible for daily operations about Risk Adjustment including: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential CMS audits and medical record retrieval efforts
  • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, and compliance with Risk adjustment production standards
  • Participate in CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits
  • Develop relationships with main individuals to foster an increased understanding of the Risk Adjustment process
  • Support in the identification of document improvement opportunities for provider education in both MA and ACA line of business
  • Identify process improvements to enhance medical encounter review efficiency
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Oscar offers health insurance with a focus on personalized care and affordable medication, leveraging technology, design, and data to humanize the healthcare experience.

Company Stage

N/A

Total Funding

$1.6B

Headquarters

New York, New York

Founded

2012

Growth & Insights
Headcount

6 month growth

2%

1 year growth

5%

2 year growth

12%

Benefits

Health insurance - That’s a given. Employees and their families receive incredible health insurance.

Financial benefits - A penny saved....we’re talking about a 401K plan, health savings accounts, and more.

Well @ Oscar - We care about your wellness with fitness classes and access to mental health support.

Work-Life Balance - We offer multiple time-off options, wellness days, and 10+ weeks of parental leave.

Learning & Development - We offer everything from mentorship to management training.