Senior Analyst, Payment Integrity - Remote

pofft; Northern (KY); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Unlimited vacation

Annual performance bonus

Benefits

Job summary

Oscar is hiring a Senior Analyst to support Payment Integrity by improving reimbursement policies, edits, and workflows. The role requires deep knowledge of Oscar's claim infrastructure and cross-functional collaboration to translate stakeholder friction into actionable improvements.

Responsibilities include researching coding rules, analyzing data for opportunities, and delivering solutions with partners. This is a flexible remote position with potential hybrid future options.

Qualifications

• Bachelor's degree or 4+ years of commensurate experience.
• Medical coding certification through AAPC or AHIMA.

Responsibilities

• Contribute as SME for reimbursement policies and internal/external edits.
• Respond to inquiries and disputes regarding policies and edits.
• Research coding rules and reimbursement policy language.
• Translate insights into business requirements and drive changes.
• Collaborate with partners to scope and deliver solutions.

Skills

Claims processing

Medical coding

Data analysis

Process improvement

Stakeholder collaboration

Education

Bachelor's degree or 4+ years of commensurate experience

Medical coding certification (AAPC CPC/COC) or AHIMA CCS/RHIT/RHIA

Job description

Oscar is hiring a Senior Analyst to support Payment Integrity by improving reimbursement policies, edits, and workflows. The role requires deep knowledge of Oscar's claim infrastructure and cross-functional collaboration to translate stakeholder friction into actionable improvements.

Responsibilities include researching coding rules, analyzing data for opportunities, and delivering solutions with partners. This is a flexible remote position with potential hybrid future options.