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sql excel reimbursement data mining payment integrity📋 Description
- Support payment integrity disputes and issue resolution.
- Scope, triage, investigate and implement improvements.
- Translate stakeholder friction into actionable opportunities.
- Collaborate cross-functionally using Oscar's claim workflows and data.
- Maintain transparency with stakeholders on progress and blockers.
🎯 Requirements
- Experience in payment integrity disputes/appeals
- 4+ years in claims processing, coding, or health care ops
- 3+ years in medical coding
- AAPC CPC or AHIMA CCS/RHIT/RHIA certs
- Knowledge of reimbursement methods and provider contracts
- 2+ years deriving insights from datasets
🎁 Benefits
- Medical, dental, and vision benefits
- Unlimited vacation program
- Annual performance bonus eligibility
- 11 paid holidays and paid sick time
- 401(k) plan participation
- Life and disability insurance
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