Senior Remote Risk Adjustment Coder – MA/ACA Expert

Oscar Health Insurance; Remote; USD 67,000 - 90,000; Full time

Job summary

A leading health insurance company is seeking a Senior Specialist in Risk Adjustment to manage operations for Medicare Advantage and ACA lines of business. This remote position requires a bachelor's degree and certifications in coding, alongside at least two years of relevant experience. Key responsibilities include daily operations, compliance with standards, and participation in audits. The position comes with a competitive salary range and extensive employee benefits including medical and dental coverage, paid leave, and a 401(k) plan.

Benefits

Medical, dental, and vision benefits

Unlimited vacation program

401(k) plan participation

Paid parental leave

Paid wellness time and reimbursements

Qualifications

• 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.
• Certified Risk Adjustment Coder (CRC) or similar certification.
• Experience coding in various EMR systems.

Responsibilities

• Manage daily operations for Risk Adjustment and medical record reviews.
• Ensure compliance with national standards and coding practices.
• Participate in audits of Risk Adjustment activities.
• Build relationships to enhance understanding of Risk Adjustment.
• Support provider education on document improvement opportunities.
• Identify process improvements for efficiency.
• Comply with all applicable laws and regulations.
• Perform other duties as assigned.

Skills

Risk adjustment coding experience

ICD-10-CM coding

Experience with EMR systems

Relationship building

Education

Bachelor's degree in a relevant field

Certified professional coder (CPC)

Certified Risk Adjustment Coder (CRC)

Job description

A leading health insurance company is seeking a Senior Specialist in Risk Adjustment to manage operations for Medicare Advantage and ACA lines of business. This remote position requires a bachelor's degree and certifications in coding, alongside at least two years of relevant experience. Key responsibilities include daily operations, compliance with standards, and participation in audits. The position comes with a competitive salary range and extensive employee benefits including medical and dental coverage, paid leave, and a 401(k) plan.