Hi, we're Oscar. Were hiring a Complaints Grievances & Appeals (CGA) Liaison to join our Clinical team in our Tempe office.
Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 & headquartered in New York City. Our goal is to make health insurance simple, transparent, & human. We need your help to do so.
About the role:
As a Grievances & Appeals Liaison, you will be responsible for the beginning-to-end process of receiving, researching & resolving new & existing member grievance cases. This includes any escalated requests in the grievance process, in accordance with state & federal regulatory requirements, & Oscar policies & procedures.
You will report into the Complaints & Grievances Team Lead.
- You will ensure the appropriate intake & creation of complaint tickets for new & existing complaint & grievance cases, while identifying the priority of each case, & routing each to the appropriate team.
- Managing your caseload & ensuring that each case has all of the required elements for processing & are responded to correctly, accurately, & within set service level standards.
- Perform complete, accurate & consistent documentation of all research, escalation pathways, & communications in Oscar systems.
- Write & manage outbound documents, correspondence & reports in required timeframes.
- Identify operational issues & trends within Oscar, delegates & other external stakeholders. Communicate these issues internally & externally, & assist in formulating appropriate remediation plans.
- Work collaboratively & cross-functionally with other departments to facilitate appropriate resolutions. Work as a team to complete departmental tasks to meet deadlines & accomplish department objectives.
- 3+ years of relevant experience in Healthcare industry i.e Compliance, Complaints, Grievances & Appeals, Quality or Project Management
- Bachelor's Degree or 2+ additional years of relevant experience
- 1+ year of experience writing or editing in a professional setting
- Experience working in a start-up environment
- Strong proficiency navigating & working in multi-system environment (customer service, case management, claims)
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 & find both belonging & support. We're on a mission to change health care -- an experience made whole by our unique backgrounds & perspectives.
We aim to make health care affordable & accessible for all, & apply this same vision to our perks & benefits, including: medical benefits, unlimited paid-time off, paid parental leave, retirement plans, company social events, stocked kitchens, wellness programs, & volunteer opportunities.
Oscar applicants are considered solely based on their qualifications, without regard to applicants disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (firstname.lastname@example.org) 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.