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Associate, Payment Integrity IBR

Oscar AI · Remote · Remote

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About Oscar AI

Oscar is an AI operations analyst that watches every location 24/7, catching revenue leaks, labor inefficiencies, and compliance risks, then delivering the alerts, reports, and action plans your team needs to fix them fast. Backed by Techstars.

About the role

The Associate, Payment Integrity, Itemized Bill Review (IBR) will be responsible for executing internal payment integrity solutions requiring billing and coding expertise with and continual improvement and development of the solutions. You will ensure claims are paid accurately and timely with the highest quality. Found on 1752vc Careers, the job board for startup and VC roles.

What they're looking for

  • A bachelor's degree or 4+ years of commensurate experience
  • 2+ years of bill / coding audit experience with a focus on hospital or facility billing (UB-04)
  • 4+ years experience in medical coding
  • Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA)
  • Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices
More about this role

Hi, we're Oscar. We're hiring an Associate, Itemized Bill Review to join our Payment Integrity team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless 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.

The Associate, Payment Integrity, Itemized Bill Review (IBR) will be responsible for executing internal payment integrity solutions requiring billing and coding expertise with and continual improvement and development of the solutions. You will ensure claims are paid accurately and timely with the highest quality. This is accomplished by leveraging a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement.

You will report into the Manager, Payment Integrity (Pre-Pay).

Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky;...

Read the full posting on Oscar AI's site ↗

Insurance Operations

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