Remote Itemized Bill Auditor & Coding Expert

Oscar Health, Inc.; United States; Remote; USD 83,000 - 109,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

Unlimited vacation

Bonus program

Job summary

Oscar Health, Inc. is hiring an Associate, Itemized Bill Reviewer to join the Payment Integrity team. You will review high-dollar itemized bills (UB-04) and ensure accurate, timely payments by applying CPT/HCPCS/ICD-10 knowledge and internal workflows.

The role is fully remote for US residents (excluding certain states) with occasional travel. Competitive base pay, bonuses, and comprehensive benefits are offered.

Qualifications

• Bachelor's degree or 4+ years of commensurate experience.
• 2+ years of bill / coding audit experience with a 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.
• Compare billed charges against contracts and guidelines to confirm proper billing.
• Apply knowledge of CPT, HCPCS, ICD-10, and MS-DRGs to validate codes.
• Prepare documentation of findings, including savings and recommended adjustments.
• Serve as SME for stakeholders on billing issues and policy language.

Skills

Billing audits

Medical coding

UB-04 familiarity

CPT/HCPCS/ ICD-10 knowledge

Data mining

Communication

Education

Bachelor's degree or 4+ years experience

AAPC CPC/COC or AHIMA CCS/RHIT/RHIA

Tools

SQL

Job description

Oscar Health, Inc. is hiring an Associate, Itemized Bill Reviewer to join the Payment Integrity team. You will review high-dollar itemized bills (UB-04) and ensure accurate, timely payments by applying CPT/HCPCS/ICD-10 knowledge and internal workflows.

The role is fully remote for US residents (excluding certain states) with occasional travel. Competitive base pay, bonuses, and comprehensive benefits are offered.