Remote Itemized Billing Reviewer - Payment Integrity

F5 Remote Jobs; United States; Remote; USD 83,000 - 109,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Paid holidays

Job summary

Oscar Health is seeking an Associate, Itemized Bill Reviewer to join the Payment Integrity team. This fully remote role is open to US residents (excluding Alaska and several states) with base pay depending on location.

You will review high-dollar itemized bills, leverage coding knowledge, and document savings opportunities while collaborating with cross-functional partners. The role reports to the Manager, Payment Integrity (Pre-Pay) and requires 2+ years in bill/coding audit and 4+ years in

Qualifications

• Bachelor's degree or 4+ years of commensurate experience.

Responsibilities

• Perform line-by-line review of high-dollar facility itemized bills and related claim forms.
• Identify and document potential billing errors including duplicate billing and improper unbundling.
• Compare billed charges against contracts and guidelines to confirm proper billing.
• Apply CPT/HCPCS/ICD-10/MS-DRG knowledge to validate codes.
• Prepare clear documentation of findings and suggested claim adjustments.
• Contribute to refinement of internal audit processes and tools.

Skills

Billing audit

Medical coding

Data analysis

SQL

Excel

Education

Bachelor's degree

Tools

SQL

Excel

Job description

Oscar Health is seeking an Associate, Itemized Bill Reviewer to join the Payment Integrity team. This fully remote role is open to US residents (excluding Alaska and several states) with base pay depending on location.

You will review high-dollar itemized bills, leverage coding knowledge, and document savings opportunities while collaborating with cross-functional partners. The role reports to the Manager, Payment Integrity (Pre-Pay) and requires 2+ years in bill/coding audit and 4+ years in