Hybrid Payment Integrity Analyst

Posted 2 months ago

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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)

Benefits

  • Employee benefits
  • Monthly vacation accrual at a rate of 15 days per year
  • Medical, dental, and vision benefits
  • 11 paid holidays
  • Paid sick time
  • Paid parental leave
  • 401(k) plan participation
  • Life and disability insurance
  • Paid wellness time and reimbursements
  • Remote / work-from-home or hybrid work arrangements

Job title

Payment Integrity Analyst

Job type

Experience level

JuniorMid level

Salary

$25 - $36 per hour

Degree requirement

No Education Requirement

Tech skills

Location requirements

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