Senior Analyst, Payment Integrity - Remote

Overview

Oscar is hiring a Senior Analyst to join our Payment Integrity team, responsible for improving documentation of processes and guidelines in the payment integrity environment.

In Short

• Contribute as a subject matter expert for reimbursement policies and payment integrity.
• Respond to inquiries and disputes regarding policies and edits.
• Research coding rules and provide input into reimbursement policy language.
• Identify payment integrity opportunities and translate into business requirements.
• Collaborate with partners to deliver solutions for adverse claim outcomes.
• Proactively identify areas of opportunity to solve problems.
• Maintain transparency with stakeholders regarding progress and blockers.
• Support objectives by providing research and analysis when issues are escalated.
• Ensure compliance with laws and regulations.
• Other duties as assigned.

Requirements

• Bachelor’s degree or 3+ years of relevant experience.
• 3+ years in claims processing, coding, auditing, or health care operations.
• Experience using SQL.
• Knowledge of reimbursement methodologies and claims processing practices.
• 2+ years deriving business insights from datasets.
• 2+ years working with large datasets using Excel or a database language.
• 1+ years improving business workflows.
• Experience in knowledge management or content development.

Benefits

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