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 CGA Liaison is responsible for the comprehensive management and resolution of complex administrative member or provider grievances and appeals. You will serve as a subject matter expert on non-clinical case resolution, focusing on sensitive member issues such as claims concerns, access barriers, benefits concerns and complex service inquiries. You will drive the resolution process to meet regulatory standards set by the health plan's governing bodies, while promoting member satisfaction and retention.
What they're looking for
- 1+ years of professional experience in a regulated industry, such as healthcare, insurance, or finance
- 1+ years of experience independently managing a demanding caseload with multi-step workflows, from initial intake through investigation, resolution, and final documentation
- 1+ years of experience with directly managing escalated customer, member or provider cases
- 1+ years of experience drafting and issuing formal written communication to member and providers
- 1+ years of experience working in a structured, workflow-driven, environment
More about this role
Hi, we're Oscar. We're hiring a Specialist, Admin Complaints, Grievances & Appeals to join our CGA & MPCT 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 CGA Liaison is responsible for the comprehensive management and resolution of complex administrative member or provider grievances and appeals. You will serve as a subject matter expert on non-clinical case resolution, focusing on sensitive member issues such as claims concerns, access barriers, benefits concerns and complex service inquiries. You will drive the resolution process to meet regulatory standards set by the health plan's governing bodies, while promoting member satisfaction and retention.
You will report into our CGA Team Lead.
Work Location: This is a remote position, open to candidates who reside in: Arizona, Texas, Florida or Georgia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the...
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