Claims Quality Control Analyst

Oscar Health

New York, NY

Expired: 11 days ago Applications are no longer accepted.

$25 to $32 Hourly
Vision , Medical , Dental , Paid Time Off , Life Insurance , Retirement
Full-Time

Job Description

Hi, we're Oscar. We're hiring a Claims Quality Control Analyst to join our Claims Quality team.

Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

The Claims Quality Control Analyst is responsible for supporting process improvement and issue resolution in the Oscar claim environment with a focus on high dollar & high risk claims. The analyst will be responsible for root-cause analysis and end-to-end process improvement initiatives.

You will report to the Claims Quality Control Associate Lead.

Work Location:

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.

If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.

You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $27.31 - $35.84 per hour. The base pay for this role in all other locations is: $24.58 - $32.26 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 10 days per year

Responsibilities

Analyze, investigate and approve high dollar claims for payment
Support leadership to scope, size, prioritize items and deliver solutions
Identifying root cause of claims issues and collaborate cross-functionally to resolve and avoid future similar issues
Utilize data analysis skills and tools to develop accurate, quantitative analyses of claims issues.
Compliance with all applicable laws and regulations
Other duties as assigned

Qualifications

2+ years of experience in claims processing, auditing and health plan operations
1+ years experience project work within claims operations
2+ years of experience working with large data sets using excel or a database language

Bonus Points

2+ years of related work experience in analytics or operations
Experience with regulatory and third party claims audits

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives..

Pay Transparency:

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.

Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Reasonable Accommodation:

Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.