Claims Examination Processor

Oscar Health; United States; Remote; USD 21,593 - 30,754; Full time

Benefits offered by this job

Employee benefits

Monthly vacation accrual (15 days per year)

Job summary

An innovative health insurance company is seeking a Claims Examination Processor to enhance its Claims Production team. This role involves processing claims, improving review processes, and fostering relationships with stakeholders. You will have the flexibility to work remotely or from the Tempe office, contributing to a collaborative environment focused on quality and efficiency. Join a forward-thinking organization dedicated to transforming health insurance with a technology-first approach. If you are detail-oriented and passionate about making a difference in healthcare, this opportunity is perfect for you.

Qualifications

• 1+ years of experience in claims processing required.
• Strong quantitative analysis skills using Excel or Google Sheets.

Responsibilities

• Process incoming work associated with Claims operations.
• Develop strong working relationships with stakeholders.

Skills

Claims Processing

Quantitative Analysis

Verbal Communication

Written Communication

Interpersonal Skills

Education

Bachelor’s Degree in Business

Bachelor’s Degree in Accounting

Bachelor’s Degree in Finance

Bachelor’s Degree in Economics

Bachelor’s Degree in Healthcare

Bachelor’s Degree in Public Policy

Bachelor’s Degree in Technology

Bachelor’s Degree in Math

Tools

Excel

Google Sheets

Job description

Hi, we're Oscar. We're hiring a Claims Examination Processor to join our Claims Production team.

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

About the role

The Claims Examination Processor processes incoming work associated with Claims operations in accordance with standard operating procedures.

You will report to the Claims Team Lead.

Work Location:

If you live within commutable distance to our Tempe office (off the 101 at University Dr), you can come into the office on a voluntary basis. Otherwise, this is a remote / work-from-home role.

You must reside in one of the following states: Alabama, Arizona, Colorado, Florida, Georgia, Illinois,Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, or Washington, D.C. Note, this list of states is subject to change.

Pay Transparency:

The base pay for this role is: $19 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities

• Develop an excellent grasp of the Administrative Operations system and overall workflows.
• Develop a comprehensive understanding of the current review processes that currently exist and additional processes needed to improve consistency and quality of review.
• Contribute to the reduction of the daily inventory.
• Form strong working relationships with internal and external stakeholders.
• Take ownership of monitoring, tracking, and statusing the health of all work-in-progress issues.
• Manage the escalation and resolution process with external vendors to ensure appropriate turnaround times (where applicable).
• Contribute to team-wide goals that support the success of Claims Productions daily operations.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Qualifications

• 1+ years previous work experience in claims processing
• 1+ years quantitative analysis skills demonstrated through the use of Excel or Google Sheets
• 1+ years strong verbal and written communications, and interpersonal interactions

Bonus Points

• A bachelor’s degree in Business, Accounting, Finance, Economics, Healthcare, Public Policy, Technology or Math
• In-depth knowledge of general Insurance and/or Health Insurance operations processing protocols and payment schemes.
• Experience manipulating and entering accurate data in a production driven environment.
• Experience handling Personal Health Information (PHI) in a professional manner.
• Demonstrated capacity to balance competing priorities and continue to execute projects with excellence.