Senior Analyst, Payment Integrity

📋 Description

• Support process improvement and issue resolution in Oscar's claim environment.
• Organize, scope, prepare, investigate, and execute solutions and improvements.
• Leverage claim workflows, data models, and platform logic to scope friction.
• Collaborate cross-functionally to translate friction into opportunities.
• Report progress and blockers to the Sr. Manager, Payment Integrity.
• Adhere to applicable laws and regulations.

🎯 Requirements

• A bachelor's degree or 4+ years of commensurate experience.
• 3+ years in claims processing, coding, auditing or health care claims operations.
• 3+ years experience in medical coding within payment integrity.
• Medical coding certification through AAPC (CPC/COC) or AHIMA (CCS/RHIT/RHIA).
• 2+ years deriving business insights from datasets.
• 1+ year improving workflows and collaborating with stakeholders; SQL bonus.

🎁 Benefits

• Medical, dental, and vision benefits
• 11 paid holidays
• Paid sick time
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance