Senior Specialist, Medical Coding Auditor, SIU - Remote

Overview

The Senior Specialist, Medical Coding Auditor, SIU, works to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to audit prepayment and/or post payment claims.

In Short

• Join Oscar's SIU team as a Medical Coding Auditor.
• Support in assessing trends and patterns in fraud, waste, and abuse (FWA).
• Audit prepayment and post payment claims.
• Coordinate activities to reduce FWA impact.
• Work in a blended culture with remote options.
• Must reside in specific states for office attendance.
• Base pay varies by location.
• Eligible for employee benefits and performance bonuses.
• Develop expertise in coding guidelines.
• Document findings and create reports.

Requirements

• 1+ years of coding or auditing experience.
• Bachelor’s degree or 4+ years of work experience.
• Certified Professional Coder (CPC) designation preferred.
• Knowledge of fraud statutes and regulations.
• Experience in health insurance claims processing.
• Experience with HIPAA and data privacy.
• Ability to translate technical jargon for non-technical users.
• Experience working with health insurance regulators.

Benefits

• Medical, dental, and vision benefits.
• 11 paid holidays and paid sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.
• Unlimited vacation program.
• Annual performance bonuses.
• Supportive work environment.