Risk Manager • Senior

Who you are

You have a strong background in risk adjustment coding, particularly with Medicare Advantage and Affordable Care Act lines of business. Your experience includes conducting medical record reviews and reporting ICD-10-CM diagnosis codes, ensuring compliance with regulations set forth by the Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS). You are detail-oriented and understand the importance of maintaining accurate records and compliance in the healthcare industry.

You thrive in a collaborative environment, working closely with management and other team members to meet departmental goals and deadlines. Your communication skills allow you to effectively engage with various stakeholders, ensuring that everyone is aligned on objectives and processes. You are proactive in identifying areas for improvement within risk adjustment processes and are committed to implementing best practices.

What you'll do

As a Risk Adjustment Coder Specialist at Oscar, you will be responsible for the daily operations related to risk adjustment, including conducting thorough medical record reviews. You will report ICD-10-CM diagnosis codes for both Medicare Advantage and Affordable Care Act lines of business, ensuring that all coding is accurate and compliant with CMS guidelines. You will also be involved in potential CMS audits and medical record retrieval efforts, working to maintain the integrity of the data.

You will collaborate with management to establish effective risk adjustment processes and contribute to the overall success of the department. Your role may require occasional travel for team meetings and company events, although the majority of your work will be completed remotely from your home office. You will play a key role in helping Oscar achieve its mission of providing high-quality health insurance services to its members.

What we offer

Oscar offers 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 and innovative environment, where your contributions directly impact the health and well-being of our members. We encourage you to apply even if your experience doesn't match every requirement, as we value diverse perspectives and backgrounds in our team.