Senior Analyst, Payment Integrity Disputes
Oscar
full-time
Posted on:
Location Type: Hybrid
Location: New York City • New York • United States
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Salary
💰 $72,036 - $94,547 per year
Job Level
About the role
- Support payment integrity disputes and issue resolution in the Oscar claim environment
- Scope, triage, investigate and execute on solutions and process improvements
- Leverage a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc.
- Work cross-functionally to translate friction from stakeholders into actionable opportunities for improvement
- Report into the Manager, Payment Integrity (Pre-Pay)
Requirements
- Experience in Payment Integrity focused on Disputes and/or appeals
- 4+ years of experience in claims processing, coding, auditing or health care operations
- 3+ years experience in medical coding
- Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA)
- Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices.
- 2+ years experience deriving business insights from datasets and solving problems
- 1+ years experience improving business workflows and processes
- 1+ years experience collaborating with internal and external stakeholders
Benefits
- Employee benefits
- Participation in Oscar's unlimited vacation program
- Annual performance bonuses
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims processingmedical codingauditingpayment integritydisputes resolutionreimbursement methodologiesprovider contract conceptsbusiness insights derivationworkflow improvementdata analysis
Soft Skills
cross-functional collaborationstakeholder communicationproblem-solvingprocess improvementactionable insights translation
Certifications
CPCCOCCCSRHITRHIA