Auditor, Risk Adjustment
Tempe, AZ · Remote
$82K - $108K/yr
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.
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Auditor, Risk Adjustment
Tempe, AZ · Remote
$82K - $108K/yr
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.
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Gilbert, AZ · Remote
$19.84 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Gilbert, AZ · Remote
$19.84 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Tucson, AZ · Remote
$19.84 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Tucson, AZ · Remote
$19.84 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Phoenix, AZ · Remote
$19.84 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Phoenix, AZ · Remote
$19.84 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Glendale, AZ · Remote
$19.84 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Glendale, AZ · Remote
$19.84 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Avondale, AZ · Remote
$19.84 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Certified Coder (Risk Adjustment Experience Required) - REMOTE
Avondale, AZ · Remote
$19.84 - $38.69/hr
Preferred Qualifications • Certified Risk Adjustment Coder (CRC). • Certified Professional Payer - Payer (CPC-P). • Certified Coding Specialist - Physician Based (CCS-P). • Familiar with HCC ...
Dental Director, Health Plan - REMOTE
Scottsdale, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Scottsdale, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Mesa, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Mesa, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
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 ...
Quick apply
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 ...
Dental Director, Health Plan - REMOTE
Phoenix, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Phoenix, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Phoenix, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Phoenix, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Tucson, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Tucson, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Scottsdale, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Scottsdale, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Gilbert, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Gilbert, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Tucson, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Tucson, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Chandler, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Chandler, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Avondale, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Avondale, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Tucson, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Tucson, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Mesa, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Mesa, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Glendale, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Dental Director, Health Plan - REMOTE
Glendale, AZ · Remote
$129K - $215K/yr
... risk management, risk adjustment, disease management and evidence-based guidelines. * Active dental licensure in Southwest region (AZ, CA, NV, NM, TX). * Active membership in a recognized ...
Remote Hcc Risk Adjustment information
What is the difference between Remote Hcc Risk Adjustment vs Remote Medical Coder?
| Aspect | Remote Hcc Risk Adjustment | Remote Medical Coder |
|---|---|---|
| Certifications | HCC Certification, CPC or CCS | CPC, CCS, or RHIT |
| Work Environment | Healthcare insurance, risk adjustment teams | Medical facilities, billing departments |
| Industry Usage | Health plans, Medicare/Medicaid | Hospitals, clinics, billing companies |
Remote Hcc Risk Adjustment specialists focus on analyzing patient data to optimize risk scores for insurance purposes, while Remote Medical Coders translate medical records into billing codes. Both roles require healthcare certifications and involve remote work, but they serve different functions within the healthcare industry.
What are popular job titles related to Remote Hcc Risk Adjustment jobs in Arizona? For Remote Hcc Risk Adjustment jobs in Arizona, the most frequently searched job titles are:
What job categories do people searching Remote Hcc Risk Adjustment jobs in Arizona look for? The top searched job categories for Remote Hcc Risk Adjustment jobs in Arizona are:
What cities in Arizona are hiring for Remote Hcc Risk Adjustment jobs? Cities in Arizona with the most Remote Hcc Risk Adjustment job openings:
$82K - $108K/yr
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 2 days ago
Key responsibilities
Conduct internal and external quality audits specific to ICD-10 code abstraction for accuracy, completeness, and clinical documentation improvement opportunities.
Review the performance of the Risk Adjustment Coding team and report audit trends to leadership to ensure appropriate changes and education are implemented.
Maintain compliance with national standards and coding practices set by ICD-10-CM coding guidelines and Risk Adjustment production standards.
Oscar Health rating
6.9
Based on 6 frontline employees who took The Breakroom Quiz
237th of 277 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.
About Oscar Health
Sourced by ZipRecruiter
Industry
Insurance services
Company size
1,001 - 5,000 Employees
Headquarters location
New York, NY, US
Year founded
2012