💼 About This Role

You'll perform medical record reviews and ICD-10-CM coding for Medicare Advantage and ACA lines of business at Oscar Health. You'll ensure compliance with CMS and HHS regulations and support audit readiness and process improvements.

🎯 What You'll Do

• Perform medical record reviews and report ICD-10-CM diagnosis codes for ACA and MA lines of business
• Maintain compliance with ICD-10-CM coding guidelines and risk adjustment production standards
• Participate in CMS audits including Risk Adjustment Data Validation audits
• Identify process improvements to enhance medical encounter review efficiency

📋 Requirements

• Bachelor's degree in relevant field or commensurate work experience
• Certified Professional Coder (CPC) certification
• 2+ years retrospective risk adjustment coding experience

✨ Nice to Have

• Certified Risk Adjustment Coder (CRC) or similar certification
• Experience coding in various Electronic Medical Record (EMR) systems

🎁 Benefits & Perks

• 🏖️ Unlimited vacation program
• 💼 Annual performance bonuses
• 🏥 Medical, dental, and vision benefits
• 👶 Paid parental leave
• 💰 401(k) plan participation

📨 Hiring Process

Estimated timeline: 2-4 weeks · AI estimate

1. 1Recruiter Screen· 30 min
2. 2Hiring Manager Interview· 45 min
3. 3Technical Assessment· 60 min