About this role
Role Overview
- Support issue resolution in the Oscar claim environment.
- Responsible for end-to-end claims repayment quality and process improvement.
- Support root cause analysis.
- Report into the VP, Payment Integrity.
- Develop and maintain expertise on coding guidelines and billing submission requirements.
- Perform policy updates or audits of documentation to determine accuracy of claims.
- Document findings clearly for non-clinicians or coders.
- Create reports and guides for team use.
- Assist in drafting communications to providers and participate in educational calls.
- Train new team members and document processes to improve team efficiency.
Requirements
- 1+ years of coding or auditing experience across multiple specialties.
- Certified Professional Coder (CPC) designation or similar certification
- Bachelor's degree or 4+ years of work experience
- Experience working in health insurance specifically with claims processing, billing, reimbursement, or provider contracting.
Benefits
- Health insurance
- 401(k) plan participation
- Unlimited vacation program
- Annual performance bonuses
- Paid holidays
- Paid sick time
- Paid parental leave
- Life and disability insurance
- Paid wellness time and reimbursements