Job Description

Hi, we're Oscar. We're hiring an Insurance Operations Processor to join our Insurance Operations team in our Tempe office. 

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need your help to do so.

ABOUT THE ROLE:

You will process incoming work associated with Claims and Eligibility operations following standard operating procedures. You will ensure accurate adjudication of claims and eligibility related functions, uncover process discrepancies, and answer escalated member and provider questions.

You will report into the Insurance Operations Manager.

RESPONSIBILITIES:

• Establish in-house expertise on all Insurance Operations-related matters to answer questions regarding the flow of work through the systems of Insurance Operations 
• Support the Insurance Ops team by identifying issues and presenting resolutions
• Take ownership of monitoring, tracking and checking status of the health of all work in progress issues
• Manage the escalation and resolution process with vendors to ensure appropriate turnaround times
• Contribute to team-wide goals to improve processes and integrate additional functions into our daily operations
• Form relationships with all partners

REQUIREMENTS:

• 3+ years of professional experience or a Bachelors degree

BONUS POINTS:

• In-depth knowledge of Insurance Operations processing protocols and payment schemes
• Knowledge of adjustment processing, medical terminology, CPT, and revenue codes
• Experience handling Personal Health Information (PHI)
• Experience manipulating and entering accurate data in a production-driven environment
• Excel and initial SQL skills (or the ability to pick it up quickly)

LIFE AT OSCAR: 

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.

We aim to make health care affordable and accessible for all, and apply this same vision to our perks and benefits, including: medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, wellness programs, and volunteer opportunities.

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.

PAY TRANSPARENCY POLICY:

Oscar ensures that you won't be discharged or discriminated against based on whether you've inquired about, discussed, or disclosed your pay. Read the full policy here.