Risk Adjustment Coder Specialist

The job

LIVE Live feed (private-sector employer) Source: The Muse public API · Data: listed 2026-11-07

Job description

Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist 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 Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes.

You will report into the Manager, Risk Adjustment.

Work Location: This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $75,348 - $98,894 per year. The base pay for this role in all other locations is: $67,813 - $89,005 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 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

• 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.

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

Explore around this job

Field: Finance and Insurance Sub-niche: Treasury, payments and risk All jobs at Oscar Health

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About the role

This is a Mid Level role in the Finance and Insurance field (Treasury, payments and risk) at Oscar Health. Mid-level roles usually expect some years of relevant experience and the ability to work with limited supervision.

We could not match this job title to one occupation in the official wage statistics, so no pay estimate is shown. Pay is not in the source listing; ask the employer for the range and compare in the 240 job niches.

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The employer

Oscar Health is the employer in this listing. See all its open jobs here →

Company description (from The Muse): Oscar is a technology-focused health insurance company.

size: Large Size; industries: Healthcare, Insurance, Technology; locations on The Muse: Flexible / Remote, Los Angeles, CA, New York, NY, Tempe, AZ.

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Same sub-niche: Treasury, payments and risk

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FAQ

What is the Risk Adjustment Coder Specialist job at Oscar Health?

A mid level role in finance and insurance (treasury, payments and risk) listed 2 days ago. The full description is on this page and on The Muse.

Where is this job?

Remote / flexible (United States). A remote or flexible location is listed; confirm with the employer which states are accepted.

How do I apply?

Use the "View this job and apply on The Muse" button. AtiveSite does not receive applications.

How much does it pay?

The listing does not publish pay, and we could not match the title to one official occupation.

What is the cost of living there?

See the state or country guide for rent, income and taxes.

How old is this listing?

It was posted on 2026-11-07 (2 days ago). Jobs older than 90 days are not shown.

Are there similar jobs?

Yes: browse treasury, payments and risk jobs in the United States.

Sources and terms

• Job data: The Muse public API (listing dated 2026-11-07). The job disappears from this site when it disappears from the source.
• Wages and projections: BLS OEWS (May 2025) and Employment Projections 2025–35.
• City and county figures: Census Bureau ACS 2020–2024, BEA, BLS QCEW and LAUS, NASA POWER climatology; distances from Census Gazetteer coordinates.

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Sources

• BLS OEWS (wages and employment by occupation, May 2025)
• BLS Employment Projections 2025–35
• BLS Local Area Unemployment Statistics
• BLS JOLTS
• BLS State and Metro Area Employment
• Census Bureau American Community Survey (via Census Reporter)
• BEA GDP by state and Regional Price Parities
• IRS 2026 tax adjustments
• U.S. Department of Labor, minimum wage by state
• Tax Foundation state income tax rates 2026
• USAJOBS
• USCIS
• U.S. Department of State, visas
• NASA POWER climatology
• GeoNames / Census Gazetteer (coordinates)