Risk Adjustment Specialist

Oscar

Risk Adjustment Specialist supporting ACA health insurance operations at Oscar Health. Managing medical-record retrieval, provider outreach, inventory tracking, and operational reporting.

Posted 8/5/2026full-timeRemote • Arizona, Florida, Illinois, Iowa, Kansas, Missouri, Montana, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia • 🇺🇸 United StatesJunior💰 $27 - $39 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Risk Adjustment operations, including medical record retrieval and provider outreach, while effectively collaborating with internal and external partners to achieve performance goals. Proficient in monitoring inventory and compliance with applicable laws and regulations.

Highest-signal resume keywords

Chart RetrievalProvider OutreachHealthcare OperationsGoal AccomplishmentCompliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Record RetrievalProvider-Level ReportingData TrackingWorkflow UnderstandingGoal Setting

Soft Skills

CollaborationInfluencing OutcomesDecision Support

Certifications & Qualifications

Bachelor's Degree

Industry Keywords

Risk AdjustmentHealthcare

About the role

Key responsibilities & impact

Support daily Risk Adjustment operations, including medical record retrieval, provider outreach, contact-information research, and creation of provider-level reports and presentations
Maintain awareness of medical-record inventory and deliverables to meet or exceed goals
Conduct outreach to internal and external partners to improve retrieval-goal performance
Represent Risk Adjustment to internal and external partners and help influence positive outcomes
Monitor, track, and status inventory
Develop an in-depth understanding of Oscar's day-to-day workflows
Learn internal tools and technical processes and identify opportunities for improvement
Support the manager by guiding ongoing decisions
Comply with all applicable laws and regulations
Perform other duties as assigned

Requirements

What you’ll need

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 being held to and accomplishing goals

Benefits

Comp & perks

Monthly vacation accrual at a rate of 15 days per year
Medical benefits
Dental benefits
Vision benefits
11 paid holidays
Paid sick time
Paid parental leave
401(k) plan participation
Life insurance
Disability insurance
Paid wellness time
Wellness reimbursements