Remote ACA Risk Adjustment Specialist

Socket.dev; United States; On-site; USD 65,000 - 90,000; Full time

Job summary

Oscar is hiring a Specialist, Risk Adjustment to join our Risk Adjustment team. The role supports our ACA program, helps meet CMS/HHS deadlines, and delivers retrospective and prospective risk adjustment work.

You will report to the Manager, Risk Adjustment Retrospective and collaborate with internal partners to drive effective risk adjustment processes. This is a remote role, open to many states, with potential for hybrid hub presence as needed.

Qualifications

• Bachelor's degree in a relevant field of study or commensurate work experience.
• 1+ years experience in chart retrieval or provider outreach.
• 1+ years of experience in Healthcare Operations.
• 2+ years of experience with being held to and accomplishing goals.

Responsibilities

• Support daily operations pertaining to Risk Adjustment including medical record retrieval, provider outreach, researching contact information, creating provider level reports and presentations.
• Maintain a grasp of our medical records inventory and deliverables to ensure we are keeping/exceed pace against goal
• Make outreach to internal and external partners to improve our ability to hit retrieval goals
• Represent Risk Adjustment to our internal and external partners and help influence positive outcomes
• Support team with monitoring, tracking, and statusing our inventory
• Develop an in-depth understanding of day-to-day workflows at Oscar
• Become acquainted with internal tools and technical processes, and highlight areas of opportunity for improvement
• Support your manager by guiding decisions on an ongoing basis
• Compliance with all applicable laws and regulations
• Other duties as assigned

Skills

chart retrieval

provider outreach

Healthcare Operations

goal oriented

Education

Bachelor's degree in a relevant field

Job description

Oscar is hiring a Specialist, Risk Adjustment to join our Risk Adjustment team. The role supports our ACA program, helps meet CMS/HHS deadlines, and delivers retrospective and prospective risk adjustment work.

You will report to the Manager, Risk Adjustment Retrospective and collaborate with internal partners to drive effective risk adjustment processes. This is a remote role, open to many states, with potential for hybrid hub presence as needed.