Remote Itemized Billing Auditor & Coding Specialist

Oscar; United States; Remote; USD 83,000 - 121,000; Full time

Benefits offered by this job

Unlimited vacation program

Annual performance bonuses

Employee benefits

Job summary

Oscar Health is hiring an Associate, Itemized Bill Reviewer to join our Payment Integrity team. The role requires billing and coding expertise to deliver accurate, timely claims processing and ongoing improvement of our solutions.

This fully remote position is open to most US locations, with occasional travel for team meetings and events. Base pay varies by state, ranging from $82,717 to $120,629 per year, plus benefits and performance bonuses.

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.
• AAPC/CPC, COC or AHIMA certifications (CCS, RHIT, RHIA) preferred.

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 of services.
• Compare billed charges against payor contracts and industry guidelines to confirm appropriate billing practices.
• Apply working knowledge of CPT, HCPCS, ICD-10, MS-DRGs to validate code accuracy.
• Review claims under specific reimbursement scenarios to ensure thresholds are met.
• Prepare clear, concise documentation of findings and recommended claim adjustments.
• Refine internal audits and tools to enhance efficiency and accuracy.
• Serve as SME for complex billing issues and payor policies.

Skills

Billing audit

Medical coding

SQL

Education

Bachelor's degree

4+ years commensurate experience

AAPC/AHIMA certification

Job description

Oscar Health is hiring an Associate, Itemized Bill Reviewer to join our Payment Integrity team. The role requires billing and coding expertise to deliver accurate, timely claims processing and ongoing improvement of our solutions.

This fully remote position is open to most US locations, with occasional travel for team meetings and events. Base pay varies by state, ranging from $82,717 to $120,629 per year, plus benefits and performance bonuses.