Find Your Dream Career

About Tekmetric Tekmetric is the all-in-one, cloud-based software helping auto repair shops run smarter, grow faster, and serve customers better. Built by a shop owner and shaped by the needs of the industry, Tekmetric brings together innovation, real-world experience, and a thriving community to help shops thrive - not just survive. From running a shop, to securing payments to engaging customers, our platform simplifies operations so shop owners can focus on what really matters: delivering exceptional service, earning trust, and growing sustainably. Officially founded in Houston in 2017, Tekmetric has grown from a single shop's vision to the industry's leading solution - all by staying true to our values of transparency, integrity, innovation, and a service-first mindset. But we're not just building shop management software. We're building a movement. We're empowering repair shops to rise above the daily grind, create meaningful connections with their customers, and lead the industry forward - one interaction at a time. Come build with us. Join the journey. Shape the future of auto repair. Working the Tekmetric Way At Tekmetric, we're building a culture where winning matters - not for ego, but because when our customers win, we win together. We move fast, stay curious, and take full ownership of our results — no excuses, no finger-pointing. If you thrive in ambiguity, take initiative, and view honest feedback as fuel for growth, you'll feel right at home here. We're direct but respectful, ambitious yet grounded, and collaborative at every level. Everyone leads through impact and is encouraged to speak up, share ideas, and challenge assumptions (even your manager's). This is a place for builders, not bystanders. Success here takes focus, follow-through, and a willingness to roll up your sleeves — but if you're driven by meaningful work and real results, it's deeply rewarding. You'll join a team that cares about the work, supports one another, and takes smart risks to achieve bold goals. Be yourself, stay mission-focused, and you'll thrive. If that energizes you, we can't wait to meet you. At Tekmetric, great work happens anywhere, but great teams are built through intentional connection . We offer hybrid and remote work models based on your proximity to our office hubs. Because we value in-person collaboration, travel is an expected part of every role. We come together several times a year for team and company-wide offsites to align on goals and strengthen relationships. Attendance at these events is expected and fully supported. What You'll Do We're looking for a Director of People Operations who is energized by what's ahead: a strong foundation to build on, a business that's moving fast, and a real opportunity to shape what comes next. This is a high-ownership, high-impact role where strategy and execution live in the same seat. You'll own the operational backbone of the People function — total rewards, HR systems, compliance, people analytics, and Finance partnership — and be a key member of the People leadership team. This role operates at all altitudes. You will focus on these areas: Operational Excellence & Scalable Systems Own and continuously improve the systems, workflows, and operating rhythms that power the employee lifecycle—from performance and compensation cycles to core people operations. Identify opportunities to simplify, automate and utilize AI to scale processes that support Tekmetric's continued growth across multi-state and international teams. Total Rewards & Compensation Strategy Lead the evolution of Tekmetric's compensation and benefits programs to ensure they remain competitive, scalable, and aligned to business goals. Oversee salary benchmarking, leveling, calibration, and rewards strategy in close partnership with Finance. Risk, Compliance & Governance Own compliance across federal, state, local, and international employment requirements—revising the policies, practices, and Legal partnerships as needed to protect the business while enabling speed and smart decision-making. People Analytics & Workforce Intelligence Leverage people data, HRIS reporting, and AI tools to surface actionable workforce insights that inform business decisions. Translate trends in retention, engagement, compensation equity, and organizational health into clear recommendations and measurable action. People Team Leadership & Functional Evolution Report to and partner closely with the VP of People & Culture while collaborating across the broader People team to continuously evolve Tekmetric's people programs, operating model, and team effectiveness as the company scales. What You'll Bring This role is for the HR/People leader who has done the real work - built programs, fixed broken processes, led and developed teams, navigated hard situations - and you're looking for a place where that experience can have real impact. You're a player-coach at heart: you get genuine energy from developing the people on your team, and you're equally energized by owning the operational work yourself. Tekmetric moves fast - and we mean it. Priorities shift, decisions happen quickly, and the expectation is that you move with the business, not behind it. If you thrive in an environment where the ground is always moving and you see that as a feature, keep reading. Here's what we're looking for: Years of Experience 10+ years of progressive People/HR experience Proven experience leading an HR/People team in a high-growth SaaS company , scaling through 40–60%+ YoY headcount growth Functional Expertise Required Employee relations, compliance, benefits, compensation, performance management, and HR operations Compensation benchmarking, leveling, and benefits program design (total rewards) HCM/HRIS platforms (Rippling would be a big plus), data integrity, reporting, and AI tools Multi-state workforce management, with international exposure preferred Leadership Experience Proven experience leading a team of 4-5 direct reports and developing HR/People professionals as a player-coach Proven experience operating independently, anticipate business needs, and designing scalable solutions Mindset & Soft Skills Builder's mentality - operating at both strategic and hands-on levels Highly analytical and data-driven, with hands-on experience leveraging data to guide decisions Strong judgment in sensitive situations, confidentiality, and decisiveness Executive presence and business acumen Strong judgment in employee relations and compliance . SHRM-CP, SHRM-SCP, PHR, or SPHR is a nice-to-have, not a requirement. What matters is the track record, the judgment, and the genuine excitement to help Tekmetric build something great - and make our people operations a true competitive advantage as we scale. Why You'll Love Working With Us Health & Wellness That Have You Covered: Enjoy the flexibility of remote work Competitive base salaries that reflect your value. Generous Paid Time Off, because we know you do your best work when you're well-rested. Support for every stage of life—with paid maternity, parental bonding, and medical leave for you or your loved ones. Comprehensive health benefits, including Medical, Dental, Vision, and Prescription coverage. For employee only, we offer plans that cover 100% of premiums and we cover 50% of costs for families. Prioritizing your mental health: get free, confidential counseling through our partnership with BetterHelp. Investing in Your Future (and Present): 401(k) Retirement Savings Plan with 100% employer match on contributions up to 6% - so your future self will thank you. Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) to make your money go further. Life and Accidental Death & Dismemberment (AD&D) Insurance for added peace of mind. Wellness on your terms: get up to $60/month toward fitness, mental health, or almost anything that helps you feel your best. After one year of employment, enjoy a $300 home office setup bonus to help make your space work for you. Keep growing with support for continuing education - we're invested in your development. Most importantly, we have a stellar team of coworkers, a really cool office, and lots of fun activities! Tekmetric is an equal opportunity employer. We hire hard-working individuals, regardless of gender, race or color, ethnicity or national origin, age, disability, religion, sexual orientation, gender identity or expression, or veteran status. We know that when our employees feel appreciated and included, they can be more creative, innovative and successful. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation. Tekmetric will never ask for your personal financial or banking information or require any financial commitment as part of our candidate search or application process. No job offers will be made without a formal interview process. All legitimate Tekmetric job postings are listed at tekmetric.com/careers . Recruiter communications come from @tekmetric .com email addresses. Please visit this link for further information Fraudulent Job Offers

Hi, we're Oscar. We're hiring a Senior Manager, Revenue Cycle Management to join our Provider Operations 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 Revenue Cycle Manager, Provider Operations is responsible for leading and optimizing revenue cycle operations across Oscar Medical Group. The role owns the development and execution of scalable revenue cycle strategies and processes that support accurate coding, compliant billing, timely reimbursement, and overall financial performance. This leader will serve as a subject matter expert in professional billing and coding and will partner closely with clinical, operations, finance, compliance, credentialing, product, to identify revenue cycle risks and opportunities and translate them into actionable operational strategies. The Senior Manager will establish performance standards, controls, reporting, and workflows across the revenue cycle while using data and root-cause analysis to drive measurable improvements in revenue capture, claims performance, coding accuracy, and provider documentation. This role will also provide strategic guidance to OMG leadership on revenue cycle performance, risks, and opportunities as the organization grows and evolves. You will report into the Director, Clinical Operations. Work Location: This is a remote position, open to candidates who reside in: Dallas, TX. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $122,212 - $160,404 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Own the strategy and performance of OMG's revenue cycle function, including professional billing, coding, claims management, denials, eligibility, documentation, and related workflows. Serve as the senior subject matter expert for coding and billing, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, and payer requirements. Establish and monitor revenue cycle KPIs and controls, using data and root-cause analysis to improve clean claims, coding accuracy, reimbursement, denial rates, and overall financial performance. Lead coding and documentation integrity strategies, including pre- and post-bill review, provider queries, addendums, signatures/co-signatures, identification of inappropriate documentation practices or cloning, and proactive provider education to address documentation gaps and support accurate coding. Lead denial prevention and resolution strategies, identifying systemic trends and partnering across teams to implement sustainable corrective actions. Partner with clinical leadership on ICD-10/HCC documentation and coding, identifying opportunities to improve accurate capture of clinically supported diagnoses. Evaluate payer-specific performance, requirements, and coding considerations, developing strategies to address reimbursement, eligibility, claim edits, denials, and other revenue cycle issues while incorporating payer expertise into coding and operational processes. Partner cross-functionally with Clinical Operations, Finance, Compliance, Credentialing, Product/Technology, and other stakeholders to resolve complex revenue cycle issues and support new programs and services. Develop scalable revenue cycle policies, workflows, governance, and vendor oversight to support a growing, multi-state provider organization. Advise OMG leadership on revenue cycle performance, financial opportunities, operational risks, and recommended strategies, leading complex initiatives from identification through implementation and measurement. Compliance with all applicable laws and regulations Other duties as assigned Requirements: 7+ years of progressive experience in healthcare revenue cycle, professional billing, coding, or related healthcare operations. 3+ years of experience leading revenue cycle programs, teams, or functions with accountability for operational and/or financial outcomes. Advanced knowledge of professional billing and coding, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, claims management, denial management, and payer requirements. Experience developing and executing revenue cycle strategies that improve coding accuracy, claims performance, reimbursement, and overall financial outcomes. Experience with coding and clinical documentation integrity, including provider documentation review, provider queries, and pre- and post-bill review processes. Demonstrated ability to analyze complex revenue cycle data, identify trends and root causes, and translate findings into actionable strategies and recommendations. Demonstrated experience leading complex, cross-functional initiatives, partnering with clinical, operations, finance, compliance, credentialing, and other stakeholders to drive results. Strong executive communication skills, with the ability to clearly communicate complex revenue cycle performance, risks, opportunities, and recommendations to senior leadership. Bonus points: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician-based (CCS-P), Certified Professional Medical Auditor (CPMA), or comparable coding/revenue cycle certification. Experience leading or overseeing coding professionals and/or certified coders. Experience working within a multi-state medical group, telehealth organization, or other complex healthcare delivery environment. Experience working within both provider and payer environments, providing an understanding of revenue cycle from both perspectives. Experience with risk-adjustment coding, including ICD-10/HCC documentation and coding practices. Experience with credentialing and payer enrollment processes and their downstream impact on revenue cycle performance. Experience managing external revenue cycle, coding, or billing vendors. 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 .

Hi, we're Oscar. We're hiring a Senior Manager, Revenue Cycle Management to join our Provider Operations 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 Revenue Cycle Manager, Provider Operations is responsible for leading and optimizing revenue cycle operations across Oscar Medical Group. The role owns the development and execution of scalable revenue cycle strategies and processes that support accurate coding, compliant billing, timely reimbursement, and overall financial performance. This leader will serve as a subject matter expert in professional billing and coding and will partner closely with clinical, operations, finance, compliance, credentialing, product, to identify revenue cycle risks and opportunities and translate them into actionable operational strategies. The Senior Manager will establish performance standards, controls, reporting, and workflows across the revenue cycle while using data and root-cause analysis to drive measurable improvements in revenue capture, claims performance, coding accuracy, and provider documentation. This role will also provide strategic guidance to OMG leadership on revenue cycle performance, risks, and opportunities as the organization grows and evolves. You will report into the Director, Clinical Operations. Work Location: This position is based in our New York City, NY office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid Pay Transparency: The base pay for this role is: $135,792.00 - $178,227.00 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Own the strategy and performance of OMG's revenue cycle function, including professional billing, coding, claims management, denials, eligibility, documentation, and related workflows. Serve as the senior subject matter expert for coding and billing, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, and payer requirements. Establish and monitor revenue cycle KPIs and controls, using data and root-cause analysis to improve clean claims, coding accuracy, reimbursement, denial rates, and overall financial performance. Lead coding and documentation integrity strategies, including pre- and post-bill review, provider queries, addendums, signatures/co-signatures, identification of inappropriate documentation practices or cloning, and proactive provider education to address documentation gaps and support accurate coding. Lead denial prevention and resolution strategies, identifying systemic trends and partnering across teams to implement sustainable corrective actions. Partner with clinical leadership on ICD-10/HCC documentation and coding, identifying opportunities to improve accurate capture of clinically supported diagnoses. Evaluate payer-specific performance, requirements, and coding considerations, developing strategies to address reimbursement, eligibility, claim edits, denials, and other revenue cycle issues while incorporating payer expertise into coding and operational processes. Partner cross-functionally with Clinical Operations, Finance, Compliance, Credentialing, Product/Technology, and other stakeholders to resolve complex revenue cycle issues and support new programs and services. Develop scalable revenue cycle policies, workflows, governance, and vendor oversight to support a growing, multi-state provider organization. Advise OMG leadership on revenue cycle performance, financial opportunities, operational risks, and recommended strategies, leading complex initiatives from identification through implementation and measurement. Compliance with all applicable laws and regulations Other duties as assigned Requirements: 7+ years of progressive experience in healthcare revenue cycle, professional billing, coding, or related healthcare operations. 3+ years of experience leading revenue cycle programs, teams, or functions with accountability for operational and/or financial outcomes. Advanced knowledge of professional billing and coding, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, claims management, denial management, and payer requirements. Experience developing and executing revenue cycle strategies that improve coding accuracy, claims performance, reimbursement, and overall financial outcomes. Experience with coding and clinical documentation integrity, including provider documentation review, provider queries, and pre- and post-bill review processes. Demonstrated ability to analyze complex revenue cycle data, identify trends and root causes, and translate findings into actionable strategies and recommendations. Demonstrated experience leading complex, cross-functional initiatives, partnering with clinical, operations, finance, compliance, credentialing, and other stakeholders to drive results. Strong executive communication skills, with the ability to clearly communicate complex revenue cycle performance, risks, opportunities, and recommendations to senior leadership. Bonus points: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician-based (CCS-P), Certified Professional Medical Auditor (CPMA), or comparable coding/revenue cycle certification. Experience leading or overseeing coding professionals and/or certified coders. Experience working within a multi-state medical group, telehealth organization, or other complex healthcare delivery environment. Experience working within both provider and payer environments, providing an understanding of revenue cycle from both perspectives. Experience with risk-adjustment coding, including ICD-10/HCC documentation and coding practices. Experience with credentialing and payer enrollment processes and their downstream impact on revenue cycle performance. Experience managing external revenue cycle, coding, or billing vendors. 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 .

Hi, we're Oscar. We're hiring a Senior Manager, Revenue Cycle Management to join our Provider Operations 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 Revenue Cycle Manager, Provider Operations is responsible for leading and optimizing revenue cycle operations across Oscar Medical Group. The role owns the development and execution of scalable revenue cycle strategies and processes that support accurate coding, compliant billing, timely reimbursement, and overall financial performance. This leader will serve as a subject matter expert in professional billing and coding and will partner closely with clinical, operations, finance, compliance, credentialing, product, to identify revenue cycle risks and opportunities and translate them into actionable operational strategies. The Senior Manager will establish performance standards, controls, reporting, and workflows across the revenue cycle while using data and root-cause analysis to drive measurable improvements in revenue capture, claims performance, coding accuracy, and provider documentation. This role will also provide strategic guidance to OMG leadership on revenue cycle performance, risks, and opportunities as the organization grows and evolves. You will report into the Director, Clinical Operations. Work Location: This position is based in our Tempe, AZ office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid Pay Transparency: The base pay for this role is: $122,212 - $160,404 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Own the strategy and performance of OMG's revenue cycle function, including professional billing, coding, claims management, denials, eligibility, documentation, and related workflows. Serve as the senior subject matter expert for coding and billing, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, and payer requirements. Establish and monitor revenue cycle KPIs and controls, using data and root-cause analysis to improve clean claims, coding accuracy, reimbursement, denial rates, and overall financial performance. Lead coding and documentation integrity strategies, including pre- and post-bill review, provider queries, addendums, signatures/co-signatures, identification of inappropriate documentation practices or cloning, and proactive provider education to address documentation gaps and support accurate coding. Lead denial prevention and resolution strategies, identifying systemic trends and partnering across teams to implement sustainable corrective actions. Partner with clinical leadership on ICD-10/HCC documentation and coding, identifying opportunities to improve accurate capture of clinically supported diagnoses. Evaluate payer-specific performance, requirements, and coding considerations, developing strategies to address reimbursement, eligibility, claim edits, denials, and other revenue cycle issues while incorporating payer expertise into coding and operational processes. Partner cross-functionally with Clinical Operations, Finance, Compliance, Credentialing, Product/Technology, and other stakeholders to resolve complex revenue cycle issues and support new programs and services. Develop scalable revenue cycle policies, workflows, governance, and vendor oversight to support a growing, multi-state provider organization. Advise OMG leadership on revenue cycle performance, financial opportunities, operational risks, and recommended strategies, leading complex initiatives from identification through implementation and measurement. Compliance with all applicable laws and regulations Other duties as assigned Requirements: 7+ years of progressive experience in healthcare revenue cycle, professional billing, coding, or related healthcare operations. 3+ years of experience leading revenue cycle programs, teams, or functions with accountability for operational and/or financial outcomes. Advanced knowledge of professional billing and coding, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, claims management, denial management, and payer requirements. Experience developing and executing revenue cycle strategies that improve coding accuracy, claims performance, reimbursement, and overall financial outcomes. Experience with coding and clinical documentation integrity, including provider documentation review, provider queries, and pre- and post-bill review processes. Demonstrated ability to analyze complex revenue cycle data, identify trends and root causes, and translate findings into actionable strategies and recommendations. Demonstrated experience leading complex, cross-functional initiatives, partnering with clinical, operations, finance, compliance, credentialing, and other stakeholders to drive results. Strong executive communication skills, with the ability to clearly communicate complex revenue cycle performance, risks, opportunities, and recommendations to senior leadership. Bonus points: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician-based (CCS-P), Certified Professional Medical Auditor (CPMA), or comparable coding/revenue cycle certification. Experience leading or overseeing coding professionals and/or certified coders. Experience working within a multi-state medical group, telehealth organization, or other complex healthcare delivery environment. Experience working within both provider and payer environments, providing an understanding of revenue cycle from both perspectives. Experience with risk-adjustment coding, including ICD-10/HCC documentation and coding practices. Experience with credentialing and payer enrollment processes and their downstream impact on revenue cycle performance. Experience managing external revenue cycle, coding, or billing vendors. 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 .

Hi, we're Oscar. We're hiring a Senior Manager, Revenue Cycle Management to join our Provider Operations 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 Revenue Cycle Manager, Provider Operations is responsible for leading and optimizing revenue cycle operations across Oscar Medical Group. The role owns the development and execution of scalable revenue cycle strategies and processes that support accurate coding, compliant billing, timely reimbursement, and overall financial performance. This leader will serve as a subject matter expert in professional billing and coding and will partner closely with clinical, operations, finance, compliance, credentialing, product, to identify revenue cycle risks and opportunities and translate them into actionable operational strategies. The Senior Manager will establish performance standards, controls, reporting, and workflows across the revenue cycle while using data and root-cause analysis to drive measurable improvements in revenue capture, claims performance, coding accuracy, and provider documentation. This role will also provide strategic guidance to OMG leadership on revenue cycle performance, risks, and opportunities as the organization grows and evolves. You will report into the Director, Clinical Operations. Work Location: This is a remote position, open to candidates who reside in: Atlanta, GA. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote Pay Transparency: The base pay for this role is: $122,212 - $160,404 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: Own the strategy and performance of OMG's revenue cycle function, including professional billing, coding, claims management, denials, eligibility, documentation, and related workflows. Serve as the senior subject matter expert for coding and billing, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, and payer requirements. Establish and monitor revenue cycle KPIs and controls, using data and root-cause analysis to improve clean claims, coding accuracy, reimbursement, denial rates, and overall financial performance. Lead coding and documentation integrity strategies, including pre- and post-bill review, provider queries, addendums, signatures/co-signatures, identification of inappropriate documentation practices or cloning, and proactive provider education to address documentation gaps and support accurate coding. Lead denial prevention and resolution strategies, identifying systemic trends and partnering across teams to implement sustainable corrective actions. Partner with clinical leadership on ICD-10/HCC documentation and coding, identifying opportunities to improve accurate capture of clinically supported diagnoses. Evaluate payer-specific performance, requirements, and coding considerations, developing strategies to address reimbursement, eligibility, claim edits, denials, and other revenue cycle issues while incorporating payer expertise into coding and operational processes. Partner cross-functionally with Clinical Operations, Finance, Compliance, Credentialing, Product/Technology, and other stakeholders to resolve complex revenue cycle issues and support new programs and services. Develop scalable revenue cycle policies, workflows, governance, and vendor oversight to support a growing, multi-state provider organization. Advise OMG leadership on revenue cycle performance, financial opportunities, operational risks, and recommended strategies, leading complex initiatives from identification through implementation and measurement. Compliance with all applicable laws and regulations Other duties as assigned Requirements: 7+ years of progressive experience in healthcare revenue cycle, professional billing, coding, or related healthcare operations. 3+ years of experience leading revenue cycle programs, teams, or functions with accountability for operational and/or financial outcomes. Advanced knowledge of professional billing and coding, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, claims management, denial management, and payer requirements. Experience developing and executing revenue cycle strategies that improve coding accuracy, claims performance, reimbursement, and overall financial outcomes. Experience with coding and clinical documentation integrity, including provider documentation review, provider queries, and pre- and post-bill review processes. Demonstrated ability to analyze complex revenue cycle data, identify trends and root causes, and translate findings into actionable strategies and recommendations. Demonstrated experience leading complex, cross-functional initiatives, partnering with clinical, operations, finance, compliance, credentialing, and other stakeholders to drive results. Strong executive communication skills, with the ability to clearly communicate complex revenue cycle performance, risks, opportunities, and recommendations to senior leadership. Bonus points: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician-based (CCS-P), Certified Professional Medical Auditor (CPMA), or comparable coding/revenue cycle certification. Experience leading or overseeing coding professionals and/or certified coders. Experience working within a multi-state medical group, telehealth organization, or other complex healthcare delivery environment. Experience working within both provider and payer environments, providing an understanding of revenue cycle from both perspectives. Experience with risk-adjustment coding, including ICD-10/HCC documentation and coding practices. Experience with credentialing and payer enrollment processes and their downstream impact on revenue cycle performance. Experience managing external revenue cycle, coding, or billing vendors. 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 .

Hi, we're Oscar. We're hiring a Senior Analyst, SIU Investigator to join our SIU 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 Analyst, Special Investigations Unit Investigator detects, investigates, and produces change in aberrant behavior observed in claims and enrollment data. You will analyze data and manage investigative caseload from identification through to resolution including overpayment recovery, measuring behavior change and completing necessary reporting to meet monetary and caseload targets through investigations and internal process improvements for Fraud Waste and Abuse (FWA) recoupments and savings. You will report into the Investigations Manager, SIU. 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: $72,036 - $94,547 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. You must be currently authorized to work in the United States on a full-time basis. Oscar will not sponsor applicants for this role. Responsibilities: Identify and conduct investigations into known or suspected FWA with high autonomy Develop documentation to substantiate findings, including formal reports, graphs, audit logs, and other supporting documentation. Meet targets through investigations and internal process improvements– which should, at least initially, increase year-over-year – for FWA recoupments and savings Perform analysis on prior cases to inform future identification of similar claims or cases and associated savings (i.e., help move from "pay-and-chase" to preventive edits and prepayment activity) Participate in the development and presentation of FWA-related education for Oscar teams Compliance with all applicable laws and regulations Other duties as assigned Requirements: 3+ years of insurance claims investigation experience or professional investigation experience with law enforcement agencies 1+ year experience with applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity Bonus points: Bachelor's degree in Criminal Justice or a related field Experience working in health insurance across several product lines specifically with claims processing, billing, reimbursement, or provider contracting. Experience with HIPAA, data privacy, and/or data security processes Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), or similar Certified Professional Coder (CPC) or similar 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 .

Hi, we're Oscar. We're hiring a Senior Analyst, SIU Investigator to join our SIU 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 Analyst, Special Investigations Unit Investigator detects, investigates, and produces change in aberrant behavior observed in claims and enrollment data. You will analyze data and manage investigative caseload from identification through to resolution including overpayment recovery, measuring behavior change and completing necessary reporting to meet monetary and caseload targets through investigations and internal process improvements for Fraud Waste and Abuse (FWA) recoupments and savings. You will report into the Investigations Manager, SIU. 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: $72,036 - $94,547 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. You must be currently authorized to work in the United States on a full-time basis. Oscar will not sponsor applicants for this role. Responsibilities: Identify and conduct investigations into known or suspected FWA with high autonomy Develop documentation to substantiate findings, including formal reports, graphs, audit logs, and other supporting documentation. Meet targets through investigations and internal process improvements– which should, at least initially, increase year-over-year – for FWA recoupments and savings Perform analysis on prior cases to inform future identification of similar claims or cases and associated savings (i.e., help move from "pay-and-chase" to preventive edits and prepayment activity) Participate in the development and presentation of FWA-related education for Oscar teams Compliance with all applicable laws and regulations Other duties as assigned Requirements: 3+ years of insurance claims investigation experience or professional investigation experience with law enforcement agencies 1+ year experience with applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity Bonus points: Bachelor's degree in Criminal Justice or a related field Experience working in health insurance across several product lines specifically with claims processing, billing, reimbursement, or provider contracting. Experience with HIPAA, data privacy, and/or data security processes Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), or similar Certified Professional Coder (CPC) or similar 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 .

Hi, we're Oscar. We're hiring a Senior Analyst, SIU Investigator to join our SIU 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 Analyst, Special Investigations Unit Investigator detects, investigates, and produces change in aberrant behavior observed in claims and enrollment data. You will analyze data and manage investigative caseload from identification through to resolution including overpayment recovery, measuring behavior change and completing necessary reporting to meet monetary and caseload targets through investigations and internal process improvements for Fraud Waste and Abuse (FWA) recoupments and savings. You will report into the Investigations Manager, SIU. 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: $72,036 - $94,547 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. You must be currently authorized to work in the United States on a full-time basis. Oscar will not sponsor applicants for this role. Responsibilities: Identify and conduct investigations into known or suspected FWA with high autonomy Develop documentation to substantiate findings, including formal reports, graphs, audit logs, and other supporting documentation. Meet targets through investigations and internal process improvements– which should, at least initially, increase year-over-year – for FWA recoupments and savings Perform analysis on prior cases to inform future identification of similar claims or cases and associated savings (i.e., help move from "pay-and-chase" to preventive edits and prepayment activity) Participate in the development and presentation of FWA-related education for Oscar teams Compliance with all applicable laws and regulations Other duties as assigned Requirements: 3+ years of insurance claims investigation experience or professional investigation experience with law enforcement agencies 1+ year experience with applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity Bonus points: Bachelor's degree in Criminal Justice or a related field Experience working in health insurance across several product lines specifically with claims processing, billing, reimbursement, or provider contracting. Experience with HIPAA, data privacy, and/or data security processes Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), or similar Certified Professional Coder (CPC) or similar 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 .

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. 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 .

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. 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 .

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. 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 .

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. 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 .