Associate, Payment Integrity - Remote

Overview

This role is responsible for supporting process improvement and issue resolution in the Oscar claim environment for both the Oscar Insurance business and Payment Integrity vendors.

In Short

• Join the Payment Integrity team at Oscar, focusing on claims processing.
• Analyze data and audit policies to ensure accurate and timely claims payments.
• Collaborate cross-functionally to identify improvement opportunities.
• Provide thought leadership on Payment Integrity processes.
• Work remotely or from one of the Oscar offices.
• Must reside in specified states for compliance.
• Base pay varies by location, with eligibility for benefits.
• Document coding rules and provide recommendations.
• Support Oscar’s objectives through research and analysis.
• Ensure compliance with laws and regulations.

Requirements

• Bachelor’s degree or 4+ years of relevant experience.
• 4+ years in claims processing, coding, or auditing.
• Expertise in Anesthesia coding guidelines.
• Medical coding certification (CPC, COC, CCS, RHIT, RHIA).
• Experience with reimbursement methodologies and claims resolution.
• Ability to work independently and drive projects.

Benefits

• Eligible for employee benefits and unlimited vacation program.
• Annual performance bonuses available.
• Comprehensive medical, dental, and vision coverage.
• Paid holidays and sick leave.
• 401(k) plan participation and life insurance.