Risk Adjustment Coder, Specialist
Oscar
full-time
Posted on:
Location Type: Remote
Location: Arizona • Florida • United States
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Salary
💰 $67,813 - $89,004 per year
About the role
- Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential CMS audits and medical record retrieval efforts.
- Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards.
- Participate in CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits.
- 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 in both MA and ACA line of business.
- Identify process improvements to enhance medical encounter review efficiency.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Requirements
- Bachelor's degree in a relevant field of study or commensurate work experience.
- Certified professional coder (CPC)
- 2+ year(s) retrospective risk adjustment coding experience.
Benefits
- Health insurance
- 401(k) plan participation
- Unlimited vacation program
- Annual performance bonuses
- Paid sick time
- Paid parental leave
- Life and disability insurance
- Paid wellness time and reimbursements
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
ICD-10-CM codingrisk adjustment codingmedical record reviewsdata validation auditsprocess improvementdocument improvement
Soft Skills
relationship buildingcommunicationcollaboration
Certifications
Certified Professional Coder (CPC)