Payment Integrity Analyst
Oscar
full-time
Posted on:
Location: Alabama, Arizona, California, Colorado • 🇺🇸 United States
Visit company websiteSalary
💰 $25 - $36 per hour
Job Level
JuniorMid-Level
Tech Stack
SQL
About the role
- Support Coordination of Benefits efforts for Payment Integrity
- Investigate and verify proper payment of Oscar medical and pharmacy claims
- Report to 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
- Ensure compliance with all applicable laws and regulations
- Other duties as assigned
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
- Must reside in one of the following states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change.
- Some experience using SQL (bonus)
- 2+ years of related work experience in Coordination of Benefits (bonus)