Oscar is hiring a
Senior Specialist
Oscar
π΅ $65k-$95k
πRemote - Worldwide
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Summary
Join Oscar as a Risk Adjustment Coder Specialist and contribute to the company's mission of changing healthcare. As a key member of the Risk Adjustment team, you will be responsible for daily operations related to risk adjustment, including medical record reviews, CMS audits, and process improvements.
Requirements
- Bachelorβs 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
Preferred Qualifications
- Certified Risk Adjustment Coder (CRC) or similar certification
- Experience coding in multiple different Electronic Medical Record (EMR) systems
Benefits
- Full-time employees are eligible for benefits including: medical, dental, and vision benefits
- 11 paid holidays
- Paid sick time
- Paid parental leave
- 401(k) plan participation
- Life and disability insurance
- Paid wellness time and reimbursements
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