Enrollment Processor (Eligibility)

Oscar-Health-; New York (NY); Remote; USD 23,000 - 33,000; Full time

Job summary

Oscar Health is seeking an Enrollment Processor (Eligibility) to join our Eligibility & Billing team in a fully remote US-based role.

Responsibilities include processing enrollment and billing tasks, handling member inquiries, and maintaining compliance with SOPs. You will report to the Associate Manager, Eligibility & Billing and may travel occasionally for team meetings and events. Base pay varies by location with eligible benefits.

Qualifications

• 1+ years of experience in administrative, customer service, data-entry, operations, healthcare, or insurance work.
• Comfort using computers, multiple systems, and standard office tools.
• Familiarity with HIPAA/privacy practices and documentation standards.
• Experience in health insurance, healthcare administration, or a regulated industry.
• Exposure to claims, eligibility/enrollment, benefits, billing, provider data, prior authorization, or member records.
• Experience working with high-volume queues.
• Clear written and verbal communication.
• Ability to manage routine, deadline-driven work and meet productivity/quality expectations.
• Ability to handle confidential member information appropriately.

Responsibilities

• Develop a comprehensive understanding of the current processes, procedures, tools, and regulations associated with Oscar's enrollment and billing business model.
• Complete various enrollment and billing tasks through multiple channels according to departmental needs and assignments.
• Manage an assigned caseload while maintaining service delivery, productivity, and quality expectations.
• Form working relationships with internal and external stakeholders.
• Support the leadership team by identifying issues through established escalation pathways.
• Be accountable for monitoring and tracking the health of all assigned work-in-progress issues.
• Escalate and resolve issues to ensure appropriate turnaround times.
• Be an active participant in process improvement initiatives.
• Comply with all operational, regulatory, and compliance standards relating to member PHI.
• Compliance with all applicable laws and regulations.
• Other duties as assigned.

Skills

Attention to detail

HIPAA privacy practices

Education

High school diploma or GED

Job description

Hi, we're Oscar. We're hiring an Enrollment Processor (Eligibility) to join our Eligibility & Billing team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless 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 E&B Production Processor is a volume-driven customer service and production based role that handles the day-to-day activities involved in running an Eligibility and Billing department at a health insurance company focused on completing back office tasks and addressing member questions in accordance with standard operating procedures.

You will report into the Associate Manager, Eligibility & Billing.

Work Location:

This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $18.31 - $24.03 per hour. The base pay for this role in all other locations is: $16.48 - $21.63 per hour. You are also eligible for employee benefits, monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

• Develop a comprehensive understanding of the current processes, procedures, tools, and regulations associated with the Oscar's enrollment and billing business model.
• Complete various enrollment and billing tasks through multiple channels according to departmental needs and assignments.
• Manage an assigned caseload while maintaining service delivery, productivity, and quality expectations
• Form working relationships with internal and external stakeholders.
• Support the leadership team by identifying issues through established escalation pathways
• Be accountable for monitoring and tracking the health of all assigned work-in-progress issues.
• Escalate and resolve issues to ensure appropriate turnaround times
• Be an active participant in process improvement initiatives
• Comply with all operational, regulatory, and compliance standards relating to member Personal Health Information (PHI)
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 1+ years of experience in administrative, customer service, data-entry, operations, healthcare, or insurance work
• High school diploma or GED
• Comfort using computers, multiple systems, and standard office tools
• Strong accuracy, attention to detail, and ability to follow written procedures
• Ability to handle confidential member information appropriately
• Clear written and verbal communication
• Ability to manage routine, deadline-driven work and meet productivity/quality expectations
• Experience in health insurance, healthcare administration, or a regulated industry
• Exposure to claims, eligibility/enrollment, benefits, billing, provider data, prior authorization, or member records
• Experience working with high-volume queues
• Familiarity with HIPAA/privacy practices and documentation standards

This is an authentic Oscar Health job opportunity.

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.

Pay Transparency:

Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI):

Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

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 ([e-mail]) to make the need for an accommodation known.

California Residents:

For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy .

Oscar Health is authorized to do business in many, but not all, states. If you are not located in or willing to relocate to a state where Oscar is registered, you will not be eligible for employment. The approved states for this role are listed in the job posting.

As set forth in Oscar Health’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.