Itemized Bill Review Pro: Billing Integrity Expert

Oscar Health; Phoenix (AZ); Hybrid; USD 83,000 - 109,000; Full time

Benefits offered by this job

Unlimited vacation

Annual performance bonuses

Job summary

Oscar Health seeks an Associate, Itemized Bill Review to join the Payment Integrity team in Tempe with a hybrid schedule (3 days in-office). You will execute internal payment integrity solutions, ensuring claims are paid accurately and timely, using deep knowledge of claim workflows and coding standards.

You will collaborate across teams, document findings, and provide expert input on edits and reimbursement policies.

Qualifications

• Bachelor's degree or 4+ years of commensurate experience.
• 2+ years of bill/coding audit experience focusing on hospital/facility (UB-04).
• 4+ years of medical coding experience.
• Certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA).
• Experience with reimbursement methodologies and provider contracts.

Responsibilities

• Perform line-by-line review of high-dollar facility itemized bills and related claim forms (UB-04).
• Identify and document potential billing errors including unbundling and non-covered services.
• Compare billed charges against contracts and guidelines to ensure proper billing.

Skills

Billing/audit

CPT/HCPCS/ICD-10

SQL

Education

Bachelor's degree or 4+ years experience

AAPC/AHIMA certification (CPC/COC/CCS/RHIT/RHIA)

Tools

SQL

Job description

Oscar Health seeks an Associate, Itemized Bill Review to join the Payment Integrity team in Tempe with a hybrid schedule (3 days in-office). You will execute internal payment integrity solutions, ensuring claims are paid accurately and timely, using deep knowledge of claim workflows and coding standards.

You will collaborate across teams, document findings, and provide expert input on edits and reimbursement policies.