COB Specialist, Payment IntegrityNew$65K–$85K
The opportunity
Hi, we're Oscar. We're hiring a COB Specialist to join our Payment Integrity team.
What you'll do
Contribute as a subject matter expert for Oscars COB reimbursement policies
Respond to internal and external inquiries and disputes regarding COB policies
Use knowledge gained through research and claims review to ideate COB: opportunities. 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 COB solutions.
Use insights from partner submissions, process monitoring, etc., work with: the team to proactively identify thematic areas of opportunity to solve COB problems.
Perpetuate a culture of transparency and collaboration by keeping: stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate.
What they're looking for
- Support Oscar run state objectives by providing speedy research, root cause: analysis, training, etc. whenever issues are escalated and assigned by leadership.
- Analyze, investigate and confirm if dual coverage exists for Oscar membership
- Utilize data analysis skills and tools to develop accurate, quantitative analyses of payment issues
- Compliance with all applicable laws and regulations
