Billing Integrity Associate, IBR (Hybrid | Unlimited PTO)

name; New York (NY); Hybrid; USD 92,000 - 121,000; Full time

Job summary

Oscar is hiring an Associate, Payment Integrity, Itemized Bill Review (IBR) to execute billing and coding audits and improve solutions. Based in NYC with a hybrid schedule and 3 in-office days weekly.

You will review high-dollar hospital bills, apply CPT/HCPCS/ICD-10 knowledge, document findings, and collaborate across teams. A bachelor’s degree or 4+ years’ experience, coding certification, and data skills are required.

Qualifications

• Bachelor's degree or 4+ years of commensurate experience.
• 2+ years of bill/coding audit experience with focus on hospital or facility billing (UB-04).
• 4+ years experience in medical coding.
• Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA).
• Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices.

Responsibilities

• Perform line-by-line review of high-dollar facility itemized bills and corresponding claim forms (e.g., UB-04s).
• Proactively identify and document potential billing errors, including duplicate billing and improper unbundling of services and charges for non-covered or non-rendered services.
• Compare billed charges against payor contracts and industry guidelines to confirm appropriate billing practices.
• Apply knowledge of CPT, HCPCS, ICD-10, MS-DRGs to validate codes used for services billed.

Skills

Billing review

Coding audit

Data analysis

SQL

Education

Bachelor's degree or 4+ years experience

Tools

Excel

Job description

Oscar is hiring an Associate, Payment Integrity, Itemized Bill Review (IBR) to execute billing and coding audits and improve solutions. Based in NYC with a hybrid schedule and 3 in-office days weekly.

You will review high-dollar hospital bills, apply CPT/HCPCS/ICD-10 knowledge, document findings, and collaborate across teams. A bachelor’s degree or 4+ years’ experience, coding certification, and data skills are required.