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Mid LevelFull-timeAWSAI
Salary Range
$51,000 - $69,000 /year
This salary is estimated based on similar roles. The actual salary may vary.
About the Role
We are looking for a Risk Adjustment Coder Specialist to join Oscar Health, a health insurance company built around a full stack technology platform. This role focuses on meeting individual and departmental goals related to Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business.
Key Responsibilities
- →Perform daily operations pertaining to Risk Adjustment, including medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business
- →Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines
- →Participate in CMS audits of Risk Adjustment activities
- →Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process
- →Support in the identification of document improvement opportunities for provider education
- →Identify process improvements to enhance medical encounter review efficiency
- →Compliance with all applicable laws and regulations
Requirements
- ✓Bachelor's degree in a relevant field of study or commensurate work experience
- ✓Certified professional coder (CPC)
- ✓2+ years of retrospective risk adjustment coding experience
