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Oscar Health // health insurance
 
New York City    Posted: Saturday, November 07, 2020
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring an Operations Analyst to join our Insurance Operations team in our NYC 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:

You will work on our Payment Integrity team within Insurance Operations. You will do everything necessary to help us build a solid operational foundation. You will be an important contributor to Oscars payment integrity operations by independently investigating & bringing to resolution complex & high-risk claims, & improve Oscars reimbursement policies. You will ensure accurate adjudication of claims & uncover process discrepancies. Additionally, we will look for you to help us improve our payment integrity processes & help support & provide direction to our claims processing team. 

You will report into the Operations Manager.

Responsibilities:

  • Have an excellent grasp of the claims system & overall workflow
  • Develop an in-depth understanding of daily workflows
  • Ingest, work through, & resolve payment integrity cases
  • Become well-acquainted with internal tools & technical processes, & develop insights into improvement opportunities
  • Become an in-house expert on all claims-related matters required to resolve payment integrity cases & provide escalation support to the claims processing team
  • Become an in-house expert on Oscars reimbursement policies to identify & measure the impact of any changes to our reimbursement policies
  • Analyze performance & identify issues & areas of opportunity for process improvements, & execute on those projects
  • Take ownership of monitoring, tracking, & "status-ing" the health of our inventory (including development of dashboards & defect monitoring/maintenance)
  • Support your team lead or manager by guiding decisions & implementation on an ongoing basis

Requirements:

  • Bachelors degree or equivalent work experience  
  • 1+ years of related work experience in healthcare, analytics, or operations 
  • Experience managing complex projects with several teams & partners
  • Experience building & improving processes
  • Experiences in policy analysis
  • Exposure to SQL
  • Data visualization skills (Tableau / Periscope)

Bonus points:

  • Exposure to payment integrity, payment policy optimization, or reimbursement policies within a health insurance company
  • Exposure to Python / R

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 encourage our members to care for their whole selves, & 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, & volunteer opportunities.

Reasonable Accommodation:

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 (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.

 
 
 
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