Senior Analyst managing payment integrity disputes and issue resolution within Oscar's claim environment. Collaborating with cross-functional teams to improve processes and deliver solutions.
Responsibilities
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
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