Senior Analyst, Payment Integrity DisputesActive$65K–$85K
The opportunity
Hi, we're Oscar. We're hiring a Senior Analyst, Payment Integrity Disputes to join our Disputes team.
What you'll do
Contribute as a subject matter expert for Oscar reimbursement policies,: payment integrity disputes, internal claims processing edits and external vendor edits.
Respond to internal and external inquiries and disputes regarding policies and edits.
Research industry standard coding rules, summarize and provide input into: reimbursement policy language and scope.
Use knowledge gained through research and claims review to ideate payment: integrity 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 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 leadership escalates and assigns issues.
- Compliance with all applicable laws and regulations
- Other duties as assigned
