Associate, Payment Integrity - Remote

Overview

The Associate, Payment Integrity role involves supporting process improvement and issue resolution in Oscar's claim environment, ensuring claims are paid accurately and timely.

In Short

• Join the Payment Integrity Team at Oscar.
• Support process improvement and issue resolution in claims processing.
• Ensure accurate and timely claims payments.
• Work cross-functionally to identify and translate issues into actionable opportunities.
• Provide subject matter expertise in claims processing edits and reimbursement policies.
• Document coding rules and recommend reimbursement policy changes.
• Provide training and education to team members.
• Conduct research and root cause analysis for escalated issues.
• Collaborate with stakeholders to maintain transparency.
• Comply with applicable laws and regulations.

Requirements

• Bachelor's degree or 4+ years of relevant experience.
• 4+ years of experience in claims processing, coding, auditing, or healthcare operations.
• Medical coding certification (CPC, COC, CCS, RHIT, RHIA).
• Experience with reimbursement methodologies and claims processing practices.
• Ability to work independently on projects.
• Bonus: Experience in a technical role or process improvement.

Benefits

• Eligible for employee benefits.
• Participation in unlimited vacation program.
• Annual performance bonuses.
• Medical, dental, and vision benefits.
• Paid holidays and sick time.
• 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.