Senior Specialist, Payment Policy - Remote

Overview

The Senior Specialist, Payment Policy is responsible for supporting payment policy activities, leveraging a strong understanding of Oscar's claim infrastructure to improve and enhance payment policies.

In Short

• Join the Payment Integrity team at Oscar.
• Support payment policy activities through investigation and analysis.
• Collaborate with internal and external partners.
• Contribute expertise in reimbursement policies and claims processing.
• Research industry coding rules and provide input into policy language.
• Identify opportunities for payment integrity improvements.
• Communicate effectively with stakeholders.
• Provide speedy research and root cause analysis for escalated issues.
• Ensure compliance with applicable laws and regulations.
• Other duties as assigned.

Requirements

• Bachelor's degree or 4+ years of relevant experience.
• 3+ years in claims processing, coding, or health care operations.
• 3+ years experience in medical coding.
• Certification in medical coding (AAPC or AHIMA).
• Experience with reimbursement methodologies and claims processing.
• 2+ years in data analysis and problem-solving.
• 1+ years in stakeholder collaboration.

Benefits

• Employee benefits and participation in unlimited vacation program.
• Annual performance bonuses.
• Health insurance benefits.
• 401(k) plan participation.
• Paid holidays and sick time.
• Paid parental leave.
• Life and disability insurance.
• Wellness time and reimbursements.