Itemized Bill Review and Medical Coding Specialist | Hybrid

Oscar Health; New York (NY); Hybrid; USD 9,100 - 121,000; Full time

Benefits offered by this job

Unlimited vacation

Performance bonuses

Medical, dental, and vision benefits

Job summary

Oscar Health is seeking an Associate, Payment Integrity, Itemized Bill Review to ensure accurate and timely payments. The role blends coding expertise with audit rigor in a hybrid NYC office, three in-office days per week.

The base pay range is $91,908–$120,629 yearly, with benefits, unlimited vacation, and performance bonuses. Responsibilities include line-by-line reviews, identifying billing errors, contract comparisons, and cross-functional collaboration to improve processes and policy

Qualifications

• Bachelor's degree or 4+ years of commensurate experience.
• 2+ years of bill/coding audit experience (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 and payor contracts.

Responsibilities

• Perform line-by-line review of high-dollar facility itemized bills and claim forms.
• Identify and document potential billing errors including unbundling and non-covered services.
• Compare billed charges against contracts and guidelines for proper billing.
• Apply CPT, HCPCS, ICD-10, MS-DRGs coding knowledge to validate codes.
• Prepare documentation of findings and recommended claim adjustments.
• Contribute to refinement of internal audit processes and tools.

Skills

Billing audit

Medical coding

Reimbursement knowledge

Education

Bachelor's degree or equivalent experience

Tools

SQL

Job description

Oscar Health is seeking an Associate, Payment Integrity, Itemized Bill Review to ensure accurate and timely payments. The role blends coding expertise with audit rigor in a hybrid NYC office, three in-office days per week.

The base pay range is $91,908–$120,629 yearly, with benefits, unlimited vacation, and performance bonuses. Responsibilities include line-by-line reviews, identifying billing errors, contract comparisons, and cross-functional collaboration to improve processes and policy