Analyst, Coordination of Benefits

Role Overview

• Support Coordination of Benefits efforts for Payment Integrity
• Investigate and verify proper payment of Oscar medical and pharmacy claims
• Report into the Senior Manager, Payment Integrity
• 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

Requirements

• 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
• Some experience using SQL (bonus)
• 2+ years of related work experience in Coordination of Benefits (bonus)

Tech Stack

• SQL

Benefits

• Health insurance
• 401(k) plan participation
• Paid time off
• 15 days vacation accrual per year
• Paid parental leave
• Life and disability insurance
• Paid wellness time and reimbursements
• 11 paid holidays