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Risk Adjustment Coder Specialist at Oscar Health - ApplyBlast

Risk Adjustment Coder Specialist

Oscar Health

2 days ago

3.0 on Glassdoor

Remote

Full Time

Senior

0 applicants

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About this role

Oscar is seeking a Risk Adjustment Coder Specialist to join its Risk Adjustment team, working remotely to support Medicare Advantage and Affordable Care Act lines of business. The role involves reviewing medical records, ensuring coding compliance, and participating in CMS audits to meet regulatory deadlines. The position requires a Certified Professional Coder with at least two years of retrospective risk adjustment coding experience.

Responsibilities

Review medical records to report ICD-10-CM diagnosis codes for ACA and MA lines of business
Participate in CMS audits and Risk Adjustment Data Validation audits
Identify process improvements to enhance medical encounter review efficiency

Skills

Qualifications

Certified professional coder (CPC)Certified Risk Adjustment Coder (CRC)

About Oscar Health

hioscar.com

Headquarters

New York, New York, United States

Company Size

1001-5000 employees

Founded

2012

View Profile

Oscar Health is a technology-driven health insurance company offering individual, family, and Medicare plans in select U.S. markets. It pairs insurance coverage with consumer-focused digital tools — a mobile app, telemedicine, and dedicated care teams — to simplify enrollment, care navigation, and claims management. Using data and provider partnerships, Oscar emphasizes preventive care, personalized support, and greater cost transparency for members.