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Analyst, Payment Integrity

Analyst, Payment Integrity

Oscar HealthDallas, TX, US
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Job Description

Job Description

Hi, we're Oscar. We're hiring an Analyst to join our Payment Integrity team.

Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

The Analyst, Payment Integrity is responsible for supporting Coordination of Benefits efforts for Payment Integrity. This role is responsible for investigating and verifying proper payment of Oscar medical and pharmacy claims.

You will report to the Senior Manager, Payment Integrity.

Work Location : This is a remote position, open to candidates who reside in : Arizona, Florida, Georgia, or Texas. #LI-Remote

Pay Transparency :

The base pay for this role is : $24.58 - $32.26 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities

  • Analyze, investigate and confirm if dual coverage exists for Oscar membership
  • Support leadership to scope, size, prioritize items and deliver Coordination of Benefits solutions
  • Utilize data analysis skills and tools to develop accurate, quantitative analyses of payment issues
  • Complete quality reviews of coordination of benefits vendor findings
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Qualifications

  • 2+ years of experience in Payment Integrity
  • 1+ years in claims processing, auditing or health care operations
  • 2+ years of experience working with large data sets using excel or a database language
  • Bonus points

  • Some experience using SQL
  • 2+ years of related work experience in Coordination of Benefits
  • This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

    At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care an experience made whole by our unique backgrounds and perspectives.

    Pay Transparency : Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including : medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

    Reasonable Accommodation : Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

    Artificial Intelligence (AI) Guidelines : Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar.

    California Residents : For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Notice to Job Applicants.

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