Oscar Health · 17 hours ago
Risk Adjustment Coder Specialist
United States
Full-time
Remote
Entry, Mid Level
$68K/yr - $89K/yr
2+ years expOscar is a health insurance company focused on serving its members through a technology-driven platform. They are seeking a Risk Adjustment Coder Specialist to manage daily operations related to Risk Adjustment, including medical record reviews and compliance with coding standards.
Health CareHealth InsuranceInsuranceInsurTech
Responsibilities
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
Qualification
Required
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
Preferred
Certified Risk Adjustment Coder (CRC) or similar certification
Experience coding in a variety of different Electronic Medical Record (EMR) systems
Benefits
Employee benefits
Participation in Oscar's unlimited vacation program
Annual performance bonuses
Medical, dental, and vision benefits
11 paid holidays
Paid sick time
Paid parental leave
401(k) plan participation
Life and disability insurance
Paid wellness time and reimbursements
Company
Oscar Health
Oscar is a health insurance company that offers individual and family plans, medicare advantages, and small group products.
1001-5000 employees
H1B Sponsorship
Oscar Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (19)
2024 (24)
2023 (22)
2022 (36)
2021 (13)
Funding
Current Stage
Public CompanyTotal Funding
$1.99BKey Investors
Tiger Global ManagementAlphabetFounders Fund
2025-09-16Post Ipo Debt· $355M
2021-03-03IPO
2020-12-17Private Equity· $140M
Leadership Team
Mark Bertolini
Chief Executive Officer
Steven B. Kelmar
Executive Vice President & COS
Recent News
2026-01-17
2026-01-16
2026-01-16
Company data provided by crunchbase