Associate, Payment Integrity

Oscar Health

New York, United States
Base: $91,908 - $120,629 py; bonus/equity: annual ...
On-site
Claims processing infrastructure
Payment policy development
Reimbursement policy language
The Payment Policy Associate manages and executes all payment policy activities, including organizing, scoping, investigating, and resolving payment policy issues

Job Summary

  • The Payment Policy Associate manages and executes all payment policy activities, including organizing, scoping, investigating, and resolving payment policy issues.
  • Analyze data mining and process monitoring to pinpoint claims payment issues, then define the scope and steps for policy remediation.
  • 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.

Matching Summary

The Payment Policy Associate manages and executes all payment policy activities, including organizing, scoping, investigating, and resolving payment policy issues.

Salary

Base: $91,908 - $120,629 per year; Bonus/Equity: annual performance bonuses; Benefits: medical, dental, vision, 11 paid holidays, sick time, parental leave, 401(k), life/disability insurance, wellness time/reimbursements

Skills & Requirements

Must-have

  • claims processing infrastructure
  • payment policy development
  • reimbursement policy language
  • industry standard coding rules
  • claims payment issues analysis

Nice-to-have

  • culture of transparency and collaboration
  • drive projects to completion independently
  • knowledge management and training
  • process improvement training

Key Requirements

  • Bachelor's degree or 4+ years experience
  • 4+ years claims processing, coding, auditing
  • 4+ years medical coding experience
  • Medical coding certification (AAPC or AHIMA)
  • Experience with reimbursement methodologies
  • 3+ years independent project completion

Work Rights

Not specified

Tailored Resume

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