Remote Itemized Bill Review Analyst - Payment Integrity

Openkrill; United States; Remote; USD 83,000 - 109,000; Full time

Job summary

Oscar Health is seeking an Associate, Payment Integrity, Itemized Bill Review to join our Payment Integrity team. You will execute billing and coding audits, ensure claims are paid accurately and timely, and translate stakeholder friction into actionable improvements.

This remote role supports multiple metro areas; you will review high-dollar itemized bills, apply CPT/HCPCS/ICD-10 knowledge, document findings, and collaborate with cross-functional partners to drive policy and process

Qualifications

• Bachelor's degree or 4+ years of commensurate experience.
• 2+ years of bill/coding audit experience focusing on hospital/ facility billing (UB-04).
• 4+ years experience in medical coding.
• Certifications in CPC/COC or CCS/RHIT/RHIA are preferred.

Responsibilities

• Perform line-by-line review of high-dollar facility itemized bills and claims forms.
• Identify billing errors, including unbundling and non-covered services.
• Compare billed charges against contracts and guidelines for accuracy.
• Apply CPT/HCPCS/ICD-10 knowledge to validate codes used for services billed.
• Document findings, savings, and recommended claim adjustments.
• Contribute to internal audit process improvements and tooling.

Skills

Billing audits

Coding audits

CPT/HCPCS/ICD-10 knowledge

Data analysis

Cross-functional collaboration

Attention to detail

Communication

Education

Bachelor's degree or 4+ years experience

Tools

UB-04

SQL

Excel

Job description

Oscar Health is seeking an Associate, Payment Integrity, Itemized Bill Review to join our Payment Integrity team. You will execute billing and coding audits, ensure claims are paid accurately and timely, and translate stakeholder friction into actionable improvements.

This remote role supports multiple metro areas; you will review high-dollar itemized bills, apply CPT/HCPCS/ICD-10 knowledge, document findings, and collaborate with cross-functional partners to drive policy and process