Claims Quality Audit Lead - Remote

Overview

The Claims Quality Audit Lead is responsible for ensuring claims audits are performed and completed timely. They are the subject matter expert for their team and a key member for reviewing payment policy.

In Short

• Provide subject matter expertise and in-depth understanding of Claims processing workflows.
• Identify claims payment issues that require action through audit findings.
• Represent claims quality in payment policy discussions.
• Provide training and education to team members.
• Act as a subject matter expert using internal and external tools.
• Responsible for quality measures within the audit team.
• Mediates audit findings with key stakeholders.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Requirements

• 3+ years of experience in healthcare claims auditing.
• 2+ years ability to work independently to drive projects to completion.
• Experience leading and coaching individual contributors.

Benefits

• Eligible for employee benefits.
• Participation in Oscar’s unlimited vacation program.
• Annual performance bonuses.