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Oscar Health // health insurance
 
Media, Full Time    Los Angeles, California, United States    Posted: Friday, September 11, 2020
 
   
 
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JOB DETAILS
 

Hi, we're Oscar. Were hiring an Editor to join our Complaints, Grievances & Appeals (CGA) team. 

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.

The Oscar Complaints, Grievance & Appeals Department plays an important role at Oscar.  We are responsible for responding to complaints from our members according to state & federal requirements.  We are Powered by People who have a passion for refactoring healthcare & are committed to Seek the Truth & to Make it Right.  

As a CGA Editor, you will be responsible for the beginning-to-end process of editing all outbound member response letters. You will ensure the language utilized in outbound member letters is clear, professional, grammatically correct, & aligns with both state & federal regulatory requirements, as well as Oscars policies & procedures. Your review of the letter will include verifying that all elements of the case have been addressed & that education & resources have been provided to assist the member in the future, if necessary. In addition, you will consistently provide feedback to team members regarding the quality of their member response letters, including any coaching opportunites, as necessary.

 

You will report into the Team Lead of CGA.

Responsibilities:

  • Ensure member response letters are reviewed, edited & sent back to team members within set state regulatory time frames
  • Evaluate member response letters for content, clarity, accuracy, & consistency
  • Meet daily & weekly production goals
  • Work as a team to complete departmental tasks to meet deadlines & accomplish department objectives. This may include evenings, weekends and/or holidays.

 

Requirements

  • High school degree or equivalent
  • Minimum one year of relevant previous experience in Appeals & Grievances, Utilization Management, or Member Services for a health plan or medical group
  • Knowledge of insurance industry & applicable state & federal laws
  • Advanced business writing & verbal communication skills

 

Preferred Education & Experience 

  • Bachelors degree
  • Bilingual English/Spanish skills 
  • Excellent organizational skills & ability to work in a fast paced environment with minimal supervision

 

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.

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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