Associate, Payment IntegrityActive$83K–$109K
The opportunity
Hi, we're Oscar. We're hiring an Associate to join our Payment Integrity team.
What you'll do
Provide subject matter expertise and in-depth understanding of Payment: Integrity internal claims processing edits, external vendor edits and Oscar reimbursement policies.
Respond to internal and external inquiries and disputes regarding policies and edits.
Document industry standard coding rules and provide recommendations on: reimbursement policy language and scope.
Ideate payment integrity opportunities based on a deep knowledge of industry: standard coding rules. Translate into business requirements; submit to and collaborate with internal partners to effectuate change.
Ingest information from internal and external partners regarding adverse: claim outcomes; collaborate with partners to scope, size, prioritize items and deliver solutions.
Use insights from partner submissions, data mining, process monitoring, etc.,: work with the team to proactively identify thematic areas of opportunity to solve problems.
What they're looking for
- Perpetuate a culture of transparency and collaboration by keeping: stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate.
- Support Oscar run state objectives by providing speedy research, root cause: analysis, training, etc. whenever issues are escalated and assigned by leadership.
- Compliance with all applicable laws and regulations
- Other duties as assigned
