Payment Integrity Analyst

New

Skills

Claims processing Cross-functional collaboration Data analysis Health care operations Medical coding Payment integrity Provider contracts Regulatory compliance Reimbursement methodologies Stakeholder communication

Join our team as a Senior Analyst in Payment Integrity Disputes, where you will support the resolution of payment integrity disputes within the Oscar claim environment. Your role will involve scoping, triaging, investigating, and implementing solutions leveraging claim data. You will work cross-functionally to translate stakeholder friction into meaningful improvements and keep stakeholders informed of progress. This remote role is open to candidates in listed US metro areas and may transition to a hybrid model.

Key Responsibilities
  • Support payment integrity disputes and resolution.
  • Scope, triage, and investigate claims to implement effective solutions.
  • Collaborate with cross-functional teams to address stakeholder concerns.
  • Report directly to the Manager of Payment Integrity.
  • Ensure compliance with applicable laws and regulations.
Required Skills & Qualifications
  • 4+ years of experience in claims processing, coding, auditing, or health care operations.
  • 3+ years of experience in medical coding.
  • AAPC CPC/COC or AHIMA CCS/RHIT/RHIA certification.
  • Familiarity with reimbursement methodologies and provider contracts.
  • 2+ years of experience deriving business insights from datasets.

No forms. Your profile is generated instantly.

Job Type: Remote

Salary: Not Disclosed

Experience: Entry

Duration: Months

Share this job:

Similar Jobs

Payment Integrity Analyst

New

Support payment integrity disputes.

Investigate and implement improvements.

Claims processing Cross-functional collaboration Data analysis Health care operations

Director of Product Compliance

Posted 6 days ago

Lead the Product Compliance function and strategy.

Scale AI-enabled workflows and automation.

Agent-based workflows AI-enabled workflows Automation tools Compliance advisory

Engagement Manager Role

Posted 6 days ago

Lead on-time delivery of Data Engine products.

Ensure SLA compliance and quality improvements.

APIs Client relationship management Cross-functional collaboration Data Engine products

Grocery Category Manager

Posted 4 days ago

Develop and execute grocery category strategies.

Manage vendor relationships and negotiate contracts.

Category strategy development Cross-functional collaboration Excel proficiency G-Suite proficiency

Senior Manager, SEO/AEO

Posted 4 days ago

Hire a Senior Manager for SEO/AEO.

Offer a remote work opportunity.

Analytics tools (e.g. Google Analytics) Content management systems Content optimization

Corporate Recruiter Contractor

Posted 4 days ago

Manage full-cycle recruiting processes.

Partner with hiring leaders for effective recruitment.

Applicant Tracking Systems Candidate sourcing Cross-functional collaboration Diversity hiring strategies

Supplement Formulation Manager

Posted 4 days ago

Evaluate new ingredients and technologies for dietary supplements.

Develop and propose innovative formulations that meet consumer needs.

Claim substantiation Consumer health trends analysis Cross-functional collaboration Emerging ingredient technologies

Corporate Recruiter Contractor

Posted 3 days ago

Manage full-cycle recruiting processes.

Collaborate with hiring leaders on recruitment strategies.

Applicant Tracking Systems (Greenhouse) Cross-functional collaboration Data analysis Diversity hiring strategies

Supplement Formulation Manager

Posted 3 days ago

Evaluate new ingredients and technologies for dietary supplements.

Propose effective dosages for consumer benefits.

Claim substantiation Consumer health trends Cross-functional collaboration Dietary supplement formulation

Senior Frontend Engineer

Posted 3 days ago

Collaborate with designers and engineers to evolve design systems.

Lead projects from concept to execution ensuring high quality.

CI/build systems Cross-functional collaboration Design Systems GraphQL

Senior Software Engineer Role

New

Develop backend APIs for customer support.

Enhance integration with Persona for ID verification.

API development Code reviews Cross-functional collaboration Integration with third-party services

Marketing Project Manager

New

Own and evolve the marketing strategy.

Plan and execute multi-channel campaigns.

Content strategy CRM platforms Cross-functional collaboration Digital marketing

Payment Integrity Analyst

New

Support payment integrity disputes.

Investigate and implement improvements.

Claims processing Cross-functional collaboration Data analysis Health care operations

TypeScript Backend Engineer

New

Deliver high-quality features with minimal guidance.

Participate in design reviews for team-wide technical solutions.

AI-assisted development API design Cross-functional collaboration Distributed systems

Staff Recruiter - GTM & G&A

Posted 6 days ago

Own full lifecycle recruiting for GTM and G&A roles.

Partner with various department leaders to enhance recruiting.

AI-driven recruiting tools Collaboration Continuous improvement Data analysis

Early Talent Recruiter

Posted 6 days ago

Manage recruitment for summer interns and early talent.

Build partnerships with universities and external organizations.

Brand ambassadorship CRM systems (Handshake LinkedIn Greenhouse)

Senior Support Account Manager

Posted 6 days ago

Advise C-suite and IAM leaders on PAM alignment.

Manage renewal pipeline proactively.

Cloud architecture Customer relationship management Cybersecurity certifications (CISSP CISM)

Senior GTM Recruiter

Posted 4 days ago

Manage full lifecycle recruiting for sales roles.

Partner with sales leaders to define excellence.

Candidate experience Data analysis Full-cycle recruiting Greenhouse

People Team Data Analyst

Posted 4 days ago

Recruit a remote People Team Data Analyst.

Focus on Talent Acquisition.

Applicant tracking systems Collaboration Communication skills Data analysis

Communications Specialist

Posted 4 days ago

Create and execute content plans for internal and external communications.

Drive employee engagement through compelling storytelling and advocacy.

Communications strategy Content creation Data analysis Digital marketing

Senior Recruiter for G&A

Posted 4 days ago

Own full-cycle recruiting for G&A and People functions.

Develop creative sourcing strategies to attract diverse talent.

ATS management Candidate experience Data analysis Diversity recruitment

Junior Data Analyst Role

Posted 4 days ago

Support modernization of IT systems.

Enhance operational performance metrics.

Collaboration Continuous improvement Data analysis Data automation

Junior Product Manager Role

Posted 4 days ago

Support product planning and development.

Collaborate with cross-functional teams.

Agile methodologies Backlog management Communication skills Confluence

Influencer Marketing Manager

Posted 4 days ago

Design and execute influencer marketing campaigns.

Build relationships with industry influencers.

Brand management Campaign management Communication skills Creative brief composition

Senior Product Manager

Posted 3 days ago

Own the GO device roadmap.

Drive strategic initiatives for the product.

Agile product management Cellular connectivity (LTE/5G/satellite) Cross-functional team leadership Data analysis

Senior Recruiter, G&A/People

Posted 3 days ago

Define hiring strategies and role requirements.

Attract high-quality and diverse talent.

ATS management Candidate experience Confidentiality Data analysis

Corporate Recruiter Contractor

Posted 3 days ago

Manage full-cycle recruiting processes.

Collaborate with hiring leaders on recruitment strategies.

Applicant Tracking Systems (Greenhouse) Cross-functional collaboration Data analysis Diversity hiring strategies

High Volume Recruiter

Posted 3 days ago

Manage full-cycle recruiting processes.

Partner with operational hiring leaders.

Applicant Tracking Systems Data analysis Diversity hiring strategies Full-cycle recruiting

Claims Vendor Strategy Manager

Posted 3 days ago

Develop and implement vendor strategies.

Set performance metrics for vendors.

AI integration Business Intelligence tools Cross-functional leadership Data analysis

Bioanalytical Principal Scientist

Posted 3 days ago

Design and execute bioanalytical experiments.

Lead and manage biomarker projects.

Assay development and validation Bioanalytical methods Data analysis ELISA techniques

Customer Success Manager

New

Drive customer outcomes and revenue growth.

Ensure measurable ROI for clients.

Account Management AI-powered search B2B Customer Success

Payment Integrity Analyst

New

Support payment integrity disputes.

Investigate and implement improvements.

Claims processing Cross-functional collaboration Data analysis Health care operations

Senior Data Scientist

New

Design analytical frameworks for auctions.

Run experiments to evaluate auction changes.

Auction mechanics Bid optimization CPC/CPM bidding Data analysis

Public Investment Fellow

New

Hiring for a remote fellow position.

Focus on public investment in food technology.

Communication skills Data analysis Investment strategy development Market trend analysis

Payment Integrity Analyst

New

Support payment integrity disputes.

Investigate and implement improvements.

Claims processing Cross-functional collaboration Data analysis Health care operations

Payment Integrity Analyst

New

Support payment integrity disputes.

Investigate and implement improvements.

Claims processing Cross-functional collaboration Data analysis Health care operations

Payment Integrity Analyst

New

Support payment integrity disputes.

Investigate and implement improvements.

Claims processing Cross-functional collaboration Data analysis Health care operations

Payment Integrity Analyst

New

Support payment integrity disputes.

Investigate and implement improvements.

Claims processing Cross-functional collaboration Data analysis Health care operations

Supplement Formulation Manager

Posted 4 days ago

Evaluate new ingredients and technologies for dietary supplements.

Develop and propose innovative formulations that meet consumer needs.

Claim substantiation Consumer health trends analysis Cross-functional collaboration Emerging ingredient technologies

Supplement Formulation Manager

Posted 3 days ago

Evaluate new ingredients and technologies for dietary supplements.

Propose effective dosages for consumer benefits.

Claim substantiation Consumer health trends Cross-functional collaboration Dietary supplement formulation

Senior Legal Director

Posted 3 days ago

Draft and negotiate commercial agreements.

Manage litigation and oversee outside counsel.

Commercial agreements Contract negotiation Corporate governance Employment law

Corporate Counsel Position

New

Negotiate and draft customer contracts.

Lead vendor contracts focused on data/privacy/security.

Business Associate Agreements (BAAs) Contract negotiation Corporate law Health tech regulations