Operations Analyst, Payment Integrity

Job Description

Hi, we're Oscar. We're hiring an Operations Analyst to join our Insurance Operations team in our New York City office.

Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need your help to do so.

About the role:

As an Operations Analyst at Oscar, you will help us build a solid operational foundation across the organization. You will assess and implement continuous improvement programs and manage Oscar's reimbursement policies. You will ensure accurate adjudication of claims and uncover process discrepancies. Additionally, we will look for you to help us improve our data and analytics capabilities, such as creating centralized productivity and savings dashboards.

You will report to the Operations Associate in New York.

Responsibilities:

• Ingest, work through, and resolve prioritized payment integrity cases
• Support creation and maintenance of payment policies
• Become an in-house expert on Oscar's reimbursement policies to identify and measure the impact of any changes to our reimbursement policies
• Have an excellent grasp of the claims system and overall workflow
• Become well-acquainted with internal tools and technical processes, and develop insights into improvement opportunities
• Become an in-house expert on all claims-related matters required to resolve payment integrity cases and provide escalation support to the claims processing team
• Take ownership of monitoring, tracking, and statusing the health of our inventory (including development of dashboards and defect monitoring/maintenance)
• Support your team lead or manager by guiding decisions and implementation on an ongoing basis

Requirements:

• Bachelor's degree or equivalent work experience
• 2+ years of related work experience in healthcare, analytics, or operations
• Project Management experience
• Experience using Microsoft Office applications and data visualization tools (e.g. Periscope, Tableau)
• Experiences in policy analysis
• Exposure to SQL, Python, or similar database languages

Bonus points:

• Exposure to payment integrity and payment policy optimization
• Experience working in Management Consulting or Investment Banking

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 and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

We encourage our members to care for their whole selves, and 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, and 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 ([email protected]) 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 .