Senior Analyst, Configuration & Claims Ops (Hybrid)

Oscar Health; Tempe (AZ); Hybrid; USD 68,000 - 89,000; Full time

Benefits offered by this job

Unlimited vacation

Annual bonus

Job summary

Oscar Health in Tempe, AZ, is seeking a Senior Analyst to join the Claims and Benefits Team. The role emphasizes improving platform configuration, processes, and operational efficiency in a hybrid work setting with three in-office days per week, Thursdays being in-office for team meetings.

You will report to the Manager, Configuration Operations and engage with internal teams to resolve escalations, manage Jira tickets, and ensure accurate configuration while advancing compliance and

Qualifications

• 2+ years working knowledge of health plan benefit concepts (e.g., deductibles, copays and other forms of cost sharing)
• 1+ year of SQL experience
• 1+ year claims processing experience
• 1+ year proficient in Microsoft Word, Excel and PowerPoint and/or comparable programs within the Google Docs Editors suite
• 1+ year experience in Jira
• Experience working in health insurance industry/claims
• Python experience

Responsibilities

• Analyze and summarize process behavior in order to expedite the design/solutioning process
• Translate configuration enabling internal teams to resolve escalations
• Process incoming Jira tickets to support member escalation resolution
• Identify and pilot opportunities to improve operational efficiency
• Triage and manage workflows of ingested items
• Investigate escalations via incoming tickets or informal pathways
• Conduct necessary maintenance work and take on ad-hoc projects associated with Contract configuration
• Compliance with all applicable laws and regulations
• Other duties as assigned
• Approve work-in-progress contact configuration inquiries to ensure configuration is possible
• Assist with the continued documentation and implementation of workflow updates and processes

Skills

SQL

Health plan concepts

Claims processing

Microsoft Office suite

Tools

Jira

Python

Google Docs Editors

Job description

Oscar Health in Tempe, AZ, is seeking a Senior Analyst to join the Claims and Benefits Team. The role emphasizes improving platform configuration, processes, and operational efficiency in a hybrid work setting with three in-office days per week, Thursdays being in-office for team meetings.

You will report to the Manager, Configuration Operations and engage with internal teams to resolve escalations, manage Jira tickets, and ensure accurate configuration while advancing compliance and