Address
SalaryHi, we're Oscar. We're hiring an Associate, Coordination of Benefits to join our Payment Integrity team.
Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
About the role
The Associate, Coordination of Benefits is responsible for ensuring that payment integrity Coordination of Benefits programs are running smoothly and effectively. Acting as the subject matter expert for their team and a key member in facilitating vendor and internal payment integrity programs. The Associate provides thought leadership for process and workflows that impact payment integrity and improve Coordination of Benefits solutions.
You will report to the Senior Manager, Payment Integrity.
Work Location:
Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.
If you live within commutable distance to our New York City office ( in Hudson Square), our Tempe office (off the 101 at University Ave), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.
You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote
Pay Transparency:
The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $93,600 - $122,850 per year. The base pay for this role in all other locations is: $84,240 - $110,565 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
Responsibilities
- Provide subject matter expertise and in-depth understanding of Coordination of Benefits workflows and program rules.
- Identify payment integrity solution issues that require action and provide steps needed to remediate the issue.
- Identify members and claims with Coordination of Benefits issues and facilitating processes to recover the payments and ensure future payment accuracy.
- Represent Coordination of Benefits payment integrity solutions in payment policy discussions and when necessary, document new policies or modifications to existing policies.
- Provide training and education to team members when necessary.
- Act as a subject matter expert using internal and external tools in order to complete audits and provide guidance to team members.
- Act as an in-house expert on data structure and visualization for various stakeholders in service operations.
- Facilitate quality review and validation of member eligibility identifications
- Compliance with all applicable laws and regulations
- Other duties as assigned
Qualifications
- 3+ years of experience in claims processing, auditing or health care operations
- 3+ years of experience in building or support Coordination of Benefits payment integrity solutions
- 2+ year(s) ability to work independently to drive projects to completion
Bonus Points
- Bachelor's degree or commensurate experience
- Some coding experience or database language exposure
- 3+ years of related work experience in analytics or operations
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care - an experience made whole by our unique backgrounds and perspectives..
Pay Transparency:
Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.
Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.
Reasonable Accommodation:
Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.
