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Freelance Remote Risk Adjustment Coder Jobs in Arizona

Oscar Health

Auditor, Risk Adjustment

Tempe, AZ · Remote

$82K - $108K/yr

Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas.

Phoenix Staff

Senior Data & AI Engineer

Phoenix, AZ · On-site +1

$50 - $60/hr

Phoenix, AZ (hybrid remote) Type: 6-month contract to hire Pay: $50-60/hr We're looking for a ... Experience with Epic or Cerner integrations, HEDIS or risk adjustment programs, MLOps tools such as ...

JM Hunter Group

Remote Truss Designer

Yuma, AZ · On-site +1

$60K - $95K/yr

Monitor project progress and make adjustments to truss designs as needed * Maintain accurate ... Knowledge of building codes and regulations If you are passionate about design and construction and ...

Arizona Department of Administration

$82K/yr

REMOTE OPTIONS, PHOENIX Categories: Business and Financial Administration, Legal/Investigations ... Risk Management Division (RMD) This position may offer the ability to work remotely, within Arizona ...

The State of Arizona

ASSOCIATE GENERAL COUNSEL

Phoenix, AZ · On-site +1

$125K - $150K/yr

Judicial, Legal/Investigations/Adjustment/Compliance DEPARTMENT OF ECONOMIC SECURITY Your Partner ... This position may be eligible for remote work within Arizona, based on business needs and ...

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Freelance Remote Risk Adjustment Coder information

What are Freelance Remote Risk Adjustment Coders?

Freelance Remote Risk Adjustment Coders are healthcare professionals who work independently from various locations to review medical records and assign codes that reflect patients’ health conditions and treatments, focusing on risk adjustment models. Their primary role is to ensure accuracy in coding so that healthcare organizations receive appropriate reimbursement and maintain compliance with regulatory standards. These coders typically work on a contract basis, using secure digital platforms to access records and submit their coding work. They must be highly knowledgeable in ICD-10-CM coding guidelines, risk adjustment methodologies (such as HCC), and HIPAA regulations.

What are the key skills and qualifications needed to thrive as a Freelance Remote Risk Adjustment Coder, and why are they important?

Thriving as a Freelance Remote Risk Adjustment Coder requires deep knowledge of medical coding (especially ICD-10-CM), risk adjustment models, and compliance standards, typically verified by certifications like CRC, CPC, or CCS. Proficiency with coding software, EHR systems, and secure remote work platforms is essential for accurate and efficient coding. Strong attention to detail, self-motivation, and reliable communication are vital soft skills for managing independent workloads and collaborating with clients remotely. These abilities ensure accurate risk score calculations, regulatory compliance, and successful client relationships in a virtual work environment.

How do Freelance Remote Risk Adjustment Coders typically manage communication and workflow with healthcare clients and team members?

Freelance Remote Risk Adjustment Coders commonly use secure online platforms and project management tools to receive assignments, submit coded charts, and communicate with healthcare providers or project managers. Maintaining clear and prompt communication via email or dedicated messaging systems is crucial to clarify documentation, resolve coding queries, and ensure deadlines are met. Coders must be proactive in scheduling regular check-ins and staying updated on client-specific guidelines, as workflows can be fast-paced and require strong organizational skills. Collaboration often involves working independently but also participating in virtual meetings or training sessions to stay aligned with team quality standards.
What are the most commonly searched types of Remote Risk Adjustment Coder jobs in Arizona? The most popular types of Remote Risk Adjustment Coder jobs in Arizona are:
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Freelance Remote Risk Adjustment Coder jobs near you
Auditor, Risk Adjustment

Auditor, Risk Adjustment

Oscar Health

Tempe, AZ • Remote

$82K - $108K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

226th of 260 rated insurance

Job description

Hi, we're Oscar. We're hiring a Associate, Risk Adjustment Auditor to join our Risk Adjustment team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Associate, Risk Adjustment Auditor conducts internal and external quality audits. Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and identified clinical documentation improvement opportunities. You will work with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs.

You will report into the Manager, Risk Adjustment.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

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 Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts.
  • Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation
  • Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented.
  • 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.
  • Conduct 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.
  • Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business.
  • Manage the implementation process improvements that will maximize risk adjustment factor increases.
  • 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)
  • 3+ year(s) retrospective risk adjustment coding experience.
  • 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV) experience

Bonus points:

  • Certified Risk Adjustment Coder (CRC) or similar certification
  • Experience coding in a variety of different Electronic Medical Record (EMR) systems.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.