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Hi, we're Oscar. We're hiring an Insurance Operations Processor to join our Insurance Operations team.

Oscar is the first health insurance company built around a full stack technology platform & a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family.

About the role

We provide the kind of health insurance we would want for ourselves. This means that we get to be creative & to build an excellent insurance operation from the ground up.

You will process incoming work associated with Claims, Medicare Advantage, Member Eligibility, Provider Data & Credentialing operations following standard operating procedures.

You will report to the Insurance Operations Manager. This is remote role. You must reside within Florida or have plans to relocate to Florida to be considered for the role. 

Responsibilities

  • Develop an excellent grasp of the Administrative Operations system & overall workflows.
  • Develop a comprehensive understanding of the current review processes that currently exist & additional processes needed to improve consistency & quality of review.
  • Become well-acquainted with internal tools & technical processes.
  • Contribute to the reduction of the daily inventory.
  • Form relationships with all partners.
  • Support the Administrative Ops team by identifying issues & presenting resolutions.
  • Take ownership of monitoring, tracking & status of all work-in-progress issues.
  • Manage the escalation & resolution process with external vendors to ensure appropriate turnaround times (where applicable).
  • Contribute to team wide goals to improve processes & integrate additional functions into our daily operations.

Qualifications

  • 1+ years previous work experience in any of the following areas: data analytics, provider data, claims processing, broker commissions, eligibility & billing .
  • Experience using Excel or Google Sheets to performing quantitative analysis

Bonus Points

  • A bachelor's degree in Business, Accounting, Finance, Economics, Healthcare, Public Policy, Technology or Math
  • In-depth knowledge of general Insurance & Health Insurance operations processing protocols & payment schemes.
  • Healthcare industry knowledge w/ DOS experience and Medicare Advantage experience
  • Experience manipulating & entering accurate data in a production environment.
  • Knowledge of adjustment processing, medical terminology, CPT, & revenue codes.
  • Experience handling Personal Health Information (PHI).
  • Experience manipulating & entering accurate data in a production-driven environment.
  • SQL skills
  • Experience with Provider groups, specifically facilities & physician groups.

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 applicant's 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.

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, 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.

COVID-19 vaccine requirements for in-person work: 

To protect the health & safety of our employees, we require any employee conducting in-person work* to be fully vaccinated against COVID-19 by their start date. If you are unable to be vaccinated due to medical or protected religious reasons, please reach out to our Benefits team at accommodations@hioscar.com to submit an accommodations request.

*Note: In-person work includes: employees required to work from our offices, employees conducting sales work in the field & employees conducting at-home or in-person visits with members.

 
 
 
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