Senior Analyst, Payment Integrity Disputes

📋 Description

• Support payment integrity disputes and issue resolution in Oscar's claim environment.
• Scope, triage, investigate, and execute on improvements to processes and workflows.
• Collaborate cross-functionally to translate stakeholder friction into actionable opportunities.
• Operate with deep knowledge of Oscar's claim infrastructure, data models, and workflows.
• Report to the Manager, Payment Integrity (Pre-Pay).

🎯 Requirements

• Experience in Payment Integrity focused on Disputes and/or appeals.
• 4+ years in claims processing, coding, auditing or health care operations.
• 3+ years experience in medical coding.
• AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA) certification.
• Experience with reimbursement methodologies and provider contract concepts.
• 2+ years deriving business insights from datasets.

🎁 Benefits

• Base pay range: $64,832 - $85,092 per year + benefits and bonuses.
• Fully remote role with potential hybrid model in the future.
• Eligibility for Oscar's unlimited vacation program and performance bonuses.
• Medical, dental, and vision benefits; 401(k) plan; life and disability insurance; wellness