Risk Adjustment Coder Specialist

Oscar Health

Miami, United States
Base: $67,813 - $89,004 py; bonus/equity: annual p...
Hybrid (remote with occasional travel)
Icd-10-cm diagnosis code reporting
Cms audit participation experience
Risk adjustment production standards compliance
Oscar Health is seeking a Risk Adjustment Coder Specialist to join their team, focusing on Medicare Advantage and ACA lines of business. The role involves ensuring compliance with coding standards, conducting medical record reviews, and participating in audits, all while promoting an inclusive work culture

Job Summary

  • The role involves daily operations pertaining to Risk Adjustment including medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business.
  • Candidates will participate in CMS audits of Risk Adjustment activities, including Risk Adjustment Data Validation audits, while maintaining compliance with national coding standards.
  • Oscar Health offers a competitive base pay range, unlimited vacation program, 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 join their team, focusing on Medicare Advantage and ACA lines of business. The role involves ensuring compliance with coding standards, conducting medical record reviews, and participating in audits, all while promoting an inclusive work culture.

Salary

Base: $67,813 - $89,004 per year; Bonus/Equity: Annual performance bonuses eligible; Benefits: Medical, dental, vision, 11 paid holidays, paid sick time, parental leave, 401(k), life/disability insurance, wellness reimbursements

Skills & Requirements

Must-have

  • ICD-10-CM diagnosis code reporting
  • CMS audit participation experience
  • Risk adjustment production standards compliance

Nice-to-have

  • Experience with various Electronic Medical Record systems
  • Process improvement identification skills
  • Provider education document improvement

Key Requirements

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

Work Rights

Must reside in Arizona, Florida, Georgia, or Texas

Tailored Resume

Cover Letter