Claims Examination Processor @ Oscar Health

Hi, we're Oscar. We're hiring a Claims Examination Processor to join our Claims Production team.

Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

The Claims Examination Processor processes incoming work associated with Claims operations in accordance with standard operating procedures.

You will report to the Claims Team Lead.

Work Location:

If you live within commutable distance to our Tempe office (off the 101 at University Dr), you can come into the office on a voluntary basis. Otherwise, this is a remote / work-from-home role.

You must reside in one of the following states: Alabama, Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, or Washington, D.C. Note, this list of states is subject to change.

Pay Transparency:

The base pay for this role is: $19 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities

Develop an excellent grasp of the Administrative Operations system and overall workflows.
Develop a comprehensive understanding of the current review processes that currently exist and additional processes needed to improve consistency and quality of review.
Contribute to the reduction of the daily inventory.
Form strong working relationships with internal and external stakeholders.
Take ownership of monitoring, tracking, and statusing the health of all work-in-progress issues.
Manage the escalation and resolution process with external vendors to ensure appropriate turnaround times (where applicable).
Contribute to team-wide goals that support the success of Claims Productions daily operations.
Compliance with all applicable laws and regulations
Other duties as assigned

Qualifications

1+ years previous work experience in claims processing
1+ years quantitative analysis skills demonstrated through the use of Excel or Google Sheets
1+ years strong verbal and written communications, and interpersonal interactions

Bonus Points

A bachelor’s degree in Business, Accounting, Finance, Economics, Healthcare, Public Policy, Technology or Math
In-depth knowledge of general Insurance and/or Health Insurance operations processing protocols and payment schemes.
Experience manipulating and entering accurate data in a production driven environment.
Experience handling Personal Health Information (PHI) in a professional manner.
Demonstrated capacity to balance competing priorities and continue to execute projects with excellence.

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraudhere.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team ([email protected]) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Notice to Job Applicants.

Claims Examination Processor

Oscar Health

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About the role

Responsibilities

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Bonus Points

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