Top 615 Risk adjustment Jobs in Dallas, Tx

Auditor, Risk Adjustment
Oscar Health —Dallas, TX
- $82,717 - $108,566 a year
- Remote
- Mid-level
- Bachelor's degree
- Travel
- Paid parental leave
- Paid holidays
Quick Apply
Utilization Review Intake Specialist
CorVel Corporation —Dallas, TX
- $16.74 - $26.92 an hour
- Full-time
- Remote
- Computer literacy
- High school diploma or GED
- Organizational skills
- Health savings account
- Disability insurance
Quick Apply
1d
CareIQ Scheduling Coordinator I
CorVel Corporation —Dallas, TX
- $15.61 - $23.82 an hour
- Full-time
- Remote
- Computer literacy
- Microsoft Office
- High school diploma or GED
- Health savings account
- Disability insurance
Quick Apply
7d
Data Verification Analyst
CorVel Corporation —Dallas, TX
- $13.38 - $23.42 an hour
- Full-time
- Remote
- Computer literacy
- High school diploma or GED
- Data entry
- Health savings account
- Disability insurance
Quick Apply
1d
Traveling Foreman
Mission Critical Interior Solutions, Inc —Lancaster, TX
- From $55,000 a year
- Overtime
- Construction site
- Mid-level
- Mentoring
- Disability insurance
- Health insurance
Quick Apply
Lead Service Technician
Divcon Controls —Irving, TX
- Full-time
- Ability to walk for extended periods
- Ability to climb stairs
- Ability to lift 50 pounds
- Paid training
- Disability insurance
Quick Apply
2d
Maintenance Tech -Industrial/Electrical *PM
Mowi USA —Arlington, TX
- Full-time
- Spanish
- Mid-level
- 3 years
- Health savings account
- Health insurance
Quick Apply
2d
Global Trade Comp Spec I
Mouser Electronics —Mansfield, TX
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Computer literacy
Claims Specialist I, Auto BI
Zurich Insurance Company Ltd. —Addison, TX
- $49,500 - $81,000 a year
- Full-time
- Hybrid work
- Mid-level
- Office
- High school diploma or GED
15h
Project Manager
Performance Contracting —Dallas, TX
- $94,000 - $125,000 a year
- Full-time
- Background check
- Customer service
- Mid-level
- AD&D insurance
- Paid holidays
Quick Apply
Level III Aerospace Maintenance Technician, Day Shift
PPG —Grand Prairie, TX
- $31.05 an hour
- Overtime
- Mid-level
- Forklift
- 3 years
Quick Apply
Building Commissioning Project Manager
CAI —Coppell, TX
- $100,000 - $150,000 a year
- Full-time
- Hybrid work
- 5 years
- Analysis skills
- Continuous improvement
- Disability insurance
- Health insurance
Quick Apply
Building Commissioning Project Manager
CAI —Dallas, TX
- $100,000 - $150,000 a year
- Full-time
- Hybrid work
- 5 years
- Analysis skills
- Continuous improvement
- Disability insurance
- Health insurance
Quick Apply
Project Manager III - Industrial
New River Electrical Corporation —Southlake, TX
- Full-time
- Construction site
- 5 years
- Engineering
10d
Operations Supervisor
Performance Team —Cedar Hill, TX
- $62,000 - $67,000 a year
- Email
- Mid-level
- High school diploma or GED
- US work authorization
- Health insurance
- Dental insurance
7d
Divisional Head of Operations
Performance Team —Cedar Hill, TX
- $180,000 - $200,000 a year
- Email
- Customer service
- Mentoring
- US work authorization
- Health insurance
- Dental insurance
Workers’ Compensation Claims Adjuster (TX License Required)
CCMSI —Dallas, TX
- $65,000 - $80,000 a year
- Hybrid work
- Spanish
- Customer service
- 5 years
- Paid holidays
- Disability insurance
7d
Multi-Line Claims Adjuster – Litigation & Liability
CCMSI —Dallas, TX
- $75,000 - $80,000 a year
- Monday to Friday
- Remote
- Microsoft Outlook
- 5 years
- Analysis skills
- Paid holidays
- Disability insurance
Multi-Line Claims Adjuster – Commercial Auto & GL/BI - Remote
CCMSI —Dallas, TX
- $75,000 - $85,000 a year
- Day shift
- Remote
- Spanish
- 5 years
- English
- Paid holidays
- Disability insurance
3d
Workers’ Compensation Claims Adjuster (TX License Required)
CCMSI —Dallas, TX
- $65,000 - $80,000 a year
- Full-time
- Hybrid work
- Spanish
- Customer service
- 5 years
- Paid holidays
- Disability insurance
6d

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risk adjustment jobs near dallas, tx

Auditor, Risk Adjustment

Oscar Health -
Dallas, TX

Quick Apply

Job Details

$82,717 - $108,566 a year

Benefits

Paid parental leave
Paid holidays
Disability insurance
Health insurance
Dental insurance
Parental leave
Vision insurance
Paid sick time

Qualifications

Certified Professional Coder

Full 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 ([email protected]) 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.

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Refine Your Search

risk adjustment jobs in dallas, tx

Auditor, Risk Adjustment

Utilization Review Intake Specialist

CareIQ Scheduling Coordinator I

Data Verification Analyst

Traveling Foreman

Lead Service Technician

Maintenance Tech -Industrial/Electrical *PM

Global Trade Comp Spec I

Claims Specialist I, Auto BI

Project Manager

Level III Aerospace Maintenance Technician, Day Shift

Building Commissioning Project Manager

Building Commissioning Project Manager

Project Manager III - Industrial

Operations Supervisor

Divisional Head of Operations

Workers’ Compensation Claims Adjuster (TX License Required)

Multi-Line Claims Adjuster – Litigation & Liability

Multi-Line Claims Adjuster – Commercial Auto & GL/BI - Remote

Workers’ Compensation Claims Adjuster (TX License Required)

I want to receive the latest job alert for risk adjustment in dallas, tx

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