ApplySarthiRisk Adjustment Coder Specialist
Oscar Health
Tailor my CV for this job, freeView job and applyYour CV rewritten for this role, from your real experience. Sign in with Google, nothing to install.
Got this interview? Our apps help you get the job.
This role on the market
8 open adjustment roles across 4 companies are on ApplySarthi right now.
- Senior FP&A Analyst - Risk AdjustmentJobgether
- Risk Adjustment Performance ConsultantOracle
- Certified Medical Coder - Risk AdjustmentPorter
What adjustment roles keep asking for: Excel (25%), SQL (25%), Accounting (12%), Financial modelling (12%), Looker (12%), Tableau (12%) — counted across their open postings here.
Oscar Health has 188 open roles listed here.
- Associate Director, FP&A
- Senior Analyst, Credentialing Data Operations
- Product Manager, Lucie Platform
- Associate, Pricing Configuration
- Senior Manager, Office of the President
Counted across 14 company job boards, updated as roles open and close.
Preparing for this interview
Interviews for adjustment roles keep coming back to Excel, SQL, Accounting, Financial modelling. Practise those questions before you sit with Oscar Health.
Questions you are likely to be asked
- Why do you want to join Oscar Health?
- Tell me about a time you disagreed with your manager. What happened?
- Where do you want to be in three years?
- What is a weakness you are working on, and how?
- Tell me about yourself, and why this role is the right next step.
Prep Sarthi gives you a free mock interview: an AI interviewer asks you questions like these out loud, from your own CV and this job, and shows your score and your weakest answer.
Practise the Risk Adjustment Coder Specialist at Oscar Health interview free →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
Requirements:
- 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.
Bonus points:
- Certified Risk Adjustment Coder (CRC) or similar certification
- Experience coding in a variety of different Electronic Medical Record (EMR) systems.
Travel required - upto 5%
This is an authentic Oscar Health job opportunity.
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.
Match this job to your CV
ApplySarthi scores your CV against this role, shows the skills you are missing, and writes a tailored version for the application.
Check my match →Similar open roles
- Associate, ActuarialOscar Health
- Associate, Health System ContractingOscar Health
- Associate Manager, Credentialing OperationsOscar Health
- Associate, Network Contracting (Northeast Region)Oscar Health
- Director, Insurance Product Filing & Lifecycle ManagementOscar Health
- Manager, Insurance Product Market ResearchOscar Health
- Program Lead, Payor Connections/InteroperabilityOscar Health
- Senior Director, Markets Strategic Advisory & IntelligenceOscar Health
Need answers during your interview? Try Live Sarthi.
Live Sarthi, an Interview Sarthi app, shows answer suggestions during the call.
- Hidden from supported screen sharingThe overlay stays out of supported Windows screen captures.
- Answers start in about 1.5 secondsResponse time varies with your connection and model.
- From your own CVYour projects and your experience, not a generic script.
- 30 minutes freeThen ₹149 for a 2-day pass with unlimited calls — you pay for the days you are interviewing, not a subscription.
A Windows app, from the same team as ApplySarthi.
Listed on greenhouse · posted 2026-11-04. ApplySarthi collects openings and links to application pages; the role is advertised by Oscar Health, not by us.