Risk Adjustment Coder Specialist

Oscar Health

Atlanta, Georgia, United States
Base: $67,813 - $89,004 py; bonus/equity: annual p...
Hybrid
Icd-10-cm coding guidelines compliance
Cms audit participation experience
Risk adjustment data validation support
Oscar Health is seeking a Risk Adjustment Coder Specialist to support their Medicare Advantage and ACA lines of business. The role involves managing risk adjustment operations, ensuring compliance with coding standards, and contributing to process improvements

Job Summary

  • The role involves reviewing medical records to report accurate ICD-10-CM diagnosis codes for Medicare Advantage and Affordable Care Act lines of business.
  • Candidates will actively participate in CMS audits, including Risk Adjustment Data Validation, while maintaining strict compliance with national coding standards.
  • Oscar Health offers a competitive salary range, unlimited vacation, annual performance bonuses, and comprehensive benefits including medical, dental, vision, and 401(k) participation.

Matching Summary

Match Score: 85

Oscar Health is seeking a Risk Adjustment Coder Specialist to support their Medicare Advantage and ACA lines of business. The role involves managing risk adjustment operations, ensuring compliance with coding standards, and contributing to process improvements.

Salary

Base: $67,813 - $89,004 per year; Bonus/Equity: Annual performance bonuses eligible; Benefits: Medical, dental, vision, 401(k), paid holidays, sick time, parental leave, wellness reimbursements

Skills & Requirements

Must-have

  • ICD-10-CM coding guidelines compliance
  • CMS audit participation experience
  • Risk Adjustment Data Validation support

Nice-to-have

  • Experience with various EMR systems
  • Process improvement identification skills
  • Provider education document development

Key Requirements

  • Bachelor's degree or commensurate work experience
  • Certified Professional Coder (CPC) certification
  • 2+ years retrospective risk adjustment coding experience

Work Rights

Must reside in Arizona, Florida, Georgia, or Texas

Tailored Resume

Cover Letter