Job Description

Hi, we're Oscar. We're hiring an Insurance Operations Processor to join our Insurance Operations 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 We provide the kind of health insurance we would want for ourselves. This means that we get to be creative and to build an excellent insurance operation from the ground up.

You will process incoming work associated with Claims, Eligibility, Provider Data and Credentialing operations following standard operating procedures.

You will report to the Insurance Operations Manager. THIS IS REMOTE ROLE. YOU MUST RESIDE WITH IN THE FOLLOWING STATE: ARIZONA OR FLORIDA

Responsibilities

• Develop an excellent grasp of the Administrative Operations system and overall workflows.
• Develop a comprehensive understanding of the current review processes that currently exist and additional processes needed to improve consistency and quality of review.
• Become well-acquainted with internal tools and technical processes.
• Contribute to the reduction of the daily inventory.
• Form relationships with all partners.
• Support the Administrative Ops team by identifying issues and presenting resolutions.
• Take ownership of monitoring, tracking and status of all work-in-progress issues.
• Manage the escalation and resolution process with external vendors to ensure appropriate turnaround times (where applicable).
• Contribute to team wide goals to improve processes and integrate additional functions into our daily operations.

Qualifications

• 1+ years previous work experience in any of the following areas: data analytics, provider data, claims processing, broker commissions, eligibility and billing .
• Experience using Excel or Google Sheets to performing quantitative analysis

Bonus Points

• A bachelor's degree in Business, Accounting, Finance, Economics, Healthcare, Public Policy, Technology or Math
• In-depth knowledge of general Insurance and Health Insurance operations processing protocols and payment schemes.
• Healthcare industry knowledge w/ DOS experience
• Experience manipulating and entering accurate data in a production environment.
• 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.
• SQL skills
• Experience with Provider groups, specifically facilities and physician groups.

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 encourage our members to care for their whole selves, and we encourage our employees to do the same with comprehensive medical benefits, generous paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, 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.

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, stocked kitchens, 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.

COVID-19 VACCINE REQUIREMENTS FOR IN-PERSON WORK: 

To protect the health and safety of our employees, we require any employee conducting in-person work* to be fully vaccinated against COVID-19 by their start date. If you are unable to be vaccinated due to medical or protected religious reasons, please reach out to our Benefits team at accommodations@hioscar.com to submit an accommodations request.

*Note: In-person work includes: employees required to work from our offices, employees conducting sales work in the field and employees conducting at-home or in-person visits with members.