Payment Integrity Analyst

New

Skills

Auditing Claims Processing Cross-Functional Collaboration Data Analysis Health Care Operations Medical Coding Payment Integrity Process Improvement Regulatory Compliance SQL

As a Senior Analyst in Payment Integrity, you will support process improvement and issue resolution within Oscar's claims environment. Your role will involve organizing, scoping, preparing, investigating, and executing solutions and improvements to enhance operational efficiency.

Key Responsibilities
  • Support process improvements and issue resolution in the claim environment.
  • Organize, scope, prepare, investigate, and execute solutions and improvements.
  • Leverage claim workflows, data models, and platform logic to identify and resolve friction points.
  • Collaborate cross-functionally to turn friction into opportunities.
  • Report progress and blockers to the Sr. Manager, Payment Integrity.
  • Ensure adherence to applicable laws and regulations.
Required Skills & Qualifications
  • Bachelor's degree or 4+ years of relevant experience.
  • 3+ years in claims processing, coding, auditing, or health care claims operations.
  • 3+ years of experience in medical coding within payment integrity.
  • Medical coding certification through AAPC (CPC/COC) or AHIMA (CCS/RHIT/RHIA).
  • 2+ years of experience deriving business insights from datasets.
  • 1+ year of experience improving workflows and collaborating with stakeholders; SQL knowledge is a bonus.

No forms. Your profile is generated instantly.

Job Type: Remote

Salary: Not Disclosed

Experience: Entry

Duration: Months

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