Simplify Logo

Full-Time

Medical Coding Auditor

Siu

Confirmed live in the last 24 hours

Oscar Health

Oscar Health

1,001-5,000 employees

Health insurance provider using technology

Social Impact
Healthcare
Fintech

Compensation Overview

$56.9k - $83kAnnually

+ Annual Performance Bonuses

Junior, Mid

Los Angeles, CA, USA + 2 more

More locations: Tempe, AZ, USA | New York, NY, USA

Hybrid role requiring in-office presence for candidates living within commutable distance to New York City, Tempe, or Los Angeles offices at least two days a week.

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Required Skills
Communications
Requirements
  • 1+ years of coding or auditing experience across multiple specialties.
  • Bachelor’s degree or 4+ years of work experience
  • Certified Professional Coder (CPC) designation or similar certification (required for SIU)
Responsibilities
  • Develops and maintains a depth of expertise on CPT, HCPCS, and ICD-10 Coding guidelines and other insurance billing submission requirements.
  • Perform complex policy updates or audits of assigned documentation (i.e. medical records or claims) on both a prepayment and/or post payment basis to determine accuracy of claims submitted to Oscar.
  • Document findings including reference to sources used to support decision making and in a way that can be easily understood by non clinicians or coders.
  • Create reports and reference guides that can be used by other team members to communicate findings or more effectively perform similar reviews.
  • Help draft written communications to providers to convey findings.
  • Participate in educational calls with providers.
  • Help train new team members.
  • Develop and document processes to improve the effectiveness of the team.
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Oscar Health provides health insurance plans for individuals, families, and small businesses, aiming to simplify the insurance experience through technology. Their services include 24/7 virtual care, allowing members to consult healthcare providers anytime, which is convenient for those needing immediate medical advice. Oscar also offers tools to help members find in-network doctors, hospitals, and pharmacies, enhancing access to care. Unlike many traditional insurers, Oscar focuses on user engagement and digital accessibility, ensuring their services are inclusive for all, including people with disabilities. The company's goal is to make healthcare more accessible and affordable while maintaining high-quality care.

Company Stage

N/A

Total Funding

$1.6B

Headquarters

New York City, New York

Founded

2012

Growth & Insights
Headcount

6 month growth

2%

1 year growth

4%

2 year growth

4%
Simplify Jobs

Simplify's Take

What believers are saying

  • Oscar Health's aim to double its membership by 2027 indicates significant growth potential and market expansion.
  • The company's strong financial performance and profitability outlook for 2024 reflect robust business health.
  • Strategic partnerships, such as the one with Sanford Health Plan, enhance member engagement and technological integration.

What critics are saying

  • The competitive health insurance market requires continuous innovation to maintain a competitive edge.
  • Dependence on ACA policies and government regulations could pose risks if there are changes in healthcare laws.

What makes Oscar Health unique

  • Oscar Health leverages technology to simplify and humanize the insurance experience, setting it apart from traditional insurers.
  • Their 24/7 virtual care services provide immediate medical consultations, enhancing accessibility and convenience for members.
  • Oscar's focus on ACA-compliant plans and transparency in pharmacy benefits positions it uniquely in the market.

Benefits

Health insurance - That’s a given. Employees and their families receive incredible health insurance.

Financial benefits - A penny saved....we’re talking about a 401K plan, health savings accounts, and more.

Well @ Oscar - We care about your wellness with fitness classes and access to mental health support.

Work-Life Balance - We offer multiple time-off options, wellness days, and 10+ weeks of parental leave.

Learning & Development - We offer everything from mentorship to management training.