Risk Manager • Senior

Who you are

You have a strong background in risk adjustment coding, particularly within the Medicare Advantage and Affordable Care Act sectors. Your experience includes working closely with management to meet departmental goals and deadlines set by regulatory bodies such as the Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS). You are detail-oriented and committed to maintaining compliance with national standards, ensuring that all processes are effective and efficient.

You possess excellent communication skills, allowing you to collaborate effectively with team members and management. Your ability to analyze medical records and report ICD-10-CM diagnosis codes is essential for this role. You are proactive in identifying potential CMS audits and are skilled in medical record retrieval efforts, ensuring that all necessary documentation is accurate and readily available.

What you'll do

As a Risk Adjustment Coder Specialist, you will be responsible for the daily operations related to risk adjustment coding. This includes conducting thorough medical record reviews to accurately report ICD-10-CM diagnosis codes for both Medicare Advantage and Affordable Care Act lines of business. You will work closely with management to establish effective risk adjustment processes and ensure compliance with all relevant regulations.

Your role will involve engaging with various stakeholders to meet individual and departmental goals. You will be expected to stay informed about changes in regulations and guidelines from CMS and HHS, adapting processes as necessary to maintain compliance. Additionally, you may be required to travel occasionally for team meetings and company events, despite primarily working from your home office.

What we offer

Oscar provides a competitive salary range of $67,813 - $89,004 per year, along with a comprehensive benefits package that includes participation in an unlimited vacation program and annual performance bonuses. You will have the opportunity to work in a supportive environment that values innovation and a member-focused approach to health insurance. We encourage you to apply even if your experience doesn't match every requirement, as we believe in the potential of diverse backgrounds and perspectives.