Risk Adjustment Coder Specialist - Remote

Overview

The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing Risk Adjustment processes.

In Short

• Join Oscar's Risk Adjustment team as a Senior Specialist.
• Work with management to achieve departmental goals.
• Engage in establishing Risk Adjustment processes.
• Perform medical record reviews and report ICD-10-CM codes.
• Maintain compliance with national standards and coding practices.
• Participate in CMS audits and Risk Adjustment activities.
• Develop relationships to enhance understanding of Risk Adjustment.
• Identify process improvements for medical encounter reviews.
• Work remotely with occasional office visits if local.
• Eligible for various employee benefits and performance bonuses.

Requirements

• Bachelor's degree in a relevant field or equivalent experience.
• Certified professional coder (CPC).
• 2+ years of retrospective risk adjustment coding experience.

Benefits

• Participation in Oscar's unlimited vacation program.
• Annual performance bonuses.
• Medical, dental, and vision benefits.
• Paid holidays and sick time.
• 401(k) plan participation and life insurance.