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

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