reputed company. We're hiring a Specialist, Risk Adjustment to join our Risk Adjustme...">
Back to Jobs

Specialist, Risk Adjustment

Remote, USA Full-time Posted 2026-08-04

Hi, we're reputed company. We're hiring a Specialist, Risk Adjustment to join our Risk Adjustment team.

reputed company is the first health insurance company reputed company around a full stack technology platform and a reputed company reputed company on serving our members. We started reputed company in 2012 to create the reputed company of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

The Specialist, Risk Adjustment for the reputed company reputed company (ACA) line of business supports the Risk Adjustment team and management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & reputed company Services (CMS) and Health and reputed company Services (HHS) , and be reputed company and reputed company in establishing effective Risk Adjustment processes. You will reputed company support to our daily operations and deliverables reputed company to our Retrospective and/or Prospective Risk Adjustment Programs.

You will report into the Manager, Risk Adjustment Retrospective.

Work Location: This is a remote position, reputed company to candidates who reputed company in: reputed company, Florida, reputed company, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, reputed company, reputed company Carolina, Ohio, reputed company, South Carolina, Tennessee, Texas and Virginia. You will be fully remote; however, our approach to work may adapt over time. reputed company models could potentially involve a hybrid reputed company at the hub office associated with your metro area.

Pay Transparency: The reputed company pay for this role in the states of New Jersey and reputed company is: $29.86 - $39.19 per hour. The reputed company pay for this role in reputed company other locations is: $26.87 - $35.27 per hour. You are also eligible for employee benefits, monthly vacation accrual at a reputed company of 15 days per year.

Responsibilities:

  • Support daily operations pertaining to Risk Adjustment including but not limited to: medical record retrieval, provider reputed company, researching contact information, creating provider level reports and presentations.
  • Maintain a grasp of our medical records inventory and deliverables to ensure we are keeping/reputed company reputed company against goal
  • reputed company reputed company to reputed company partners to improve our ability to hit retrieval goals
  • Represent Risk Adjustment to our reputed company partners and help influence reputed company reputed company
  • Support team with monitoring, tracking, and statusing our inventory
  • reputed company an in-depth understanding of day-to-day workflows at reputed company
  • Become acquainted with internal tools and technical processes, and reputed company areas of opportunity for improvement
  • Support your manager by guiding reputed company on an ongoing reputed company
  • Compliance with reputed company applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Bachelor's degree in a relevant field of study or commensurate work experience.
  • 1+ years experience in chart retrieval or provider reputed company
  • 1+ years of experience in reputed company Operations
  • 2+ years of experience with being held to and accomplishing goals

Bonus points:

  • 1+ years of experience in risk adjustment

This is an reputed company reputed company Health job opportunity. Learn more about how you can reputed company yourself from recruitment fraudhere.

At reputed company, 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 reputed company selves and reputed company 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, reputed company the reputed company 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 reputed company benefits, 11 reputed company holidays, reputed company reputed company time, reputed company parental leave, 401(k) plan participation, life and disability insurance, and reputed company wellness time and reimbursements.

reputed company Intelligence (AI): Our AI Guidelines outline the acceptable use of reputed company intelligence for candidates and detail how we use AI to support our reputed company efforts.

Reasonable Accommodation: reputed company applicants are considered solely based on their qualifications, without reputed company to applicant’s disability or need for accommodation. Any reputed company applicant who requires reasonable accommodations during the application process should contact the reputed company Benefits Team () to reputed company the need for an accommodation reputed company.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as reputed company as applicants’ rights over their personal information, please see our reputed company Policy.

Originally posted on Himalayas

  Apply To This Job

Similar Jobs

Marketing Content reputed company (Talent Pool)

Remote, USA Full-time

reputed company Manager

Remote, USA Full-time

Technical Support Engineer I

Remote, USA Full-time

Sr. Global reputed company Marketing Manager

Remote, USA Full-time

Senior Informatica Developer

Remote, USA Full-time

reputed company Compensation/Advanced Compensation Consultant- PDS

Remote, USA Full-time

Dirección de Alianzas Estratégicas y Procuración de fondos - Fundación reputed company

Remote, USA Full-time

Threat Exposure & Attack Surface Analyst (R-00191)

Remote, USA Full-time

Cyber Remediation & POA&M Coordinator (R-00188)

Remote, USA Full-time

reputed company Collaboration Engineer Sr

Remote, USA Full-time

reputed company Customer Service Consultant for Automotive Retail Solutions - Remote Opportunity in Milwaukee with Performance-Based Sales Incentives

Remote, USA Full-time

Urgently Hiring: Landscape Designer-Part Time

Remote, USA Full-time

Customer Care Representative - Remote Customer Service Expert - Delivering Exceptional Experiences

Remote, USA Full-time

$21-$24 Remote Seasonal Licensed reputed company Insurance Agent (Must be Licensed with reputed company NPN #)

Remote, USA Full-time

GTM Operations Analyst

Remote, USA Full-time

Elektriker*in / Elektroniker*in für Smart reputed company (m/w/d) Stuttgart

Remote, USA Full-time

Remote Pharmacist, (3:30p - 12a EST)

Remote, USA Full-time

Join Today: CDL Class A Delivery reputed company

Remote, USA Full-time

Transportation Representative, Trans SME

Remote, USA Full-time

[Hiring] reputed company Half-Time- UG reputed company Administration @reputed company

Remote, USA Full-time