Senior Analyst, SIU Investigator (Fully Remote)

Oscar Health; United States; Remote; USD 80,000 - 110,000; Full time

Benefits offered by this job

Unlimited vacation

Paid parental leave

Paid wellness time

Job summary

Oscar Health is seeking an investigator to detect and investigate aberrant behavior in claims and enrollment data. The role requires handling cases from identification to resolution, including recovery of overpayments, with attention to fraud statutes and federal recoupment guidelines.

The position offers a meaningful impact on health insurance operations and compliance, with a focus on accuracy, integrity, and efficient case closure.

Qualifications

• 3+ years of insurance claims or professional investigation experience.
• 1+ year experience with fraud statutes and federal recoupment guidelines.

Responsibilities

• Detect and investigate aberrant behavior in claims and enrollment data.
• Manage cases from identification to resolution, including overpayment recovery.

Skills

Investigative experience

Fraud regulations

Job description

• Detect and investigate aberrant behavior in claims and enrollment data.
• Manage cases from identification to resolution, including overpayment recovery.

Requirements:

• 3+ years of insurance claims or professional investigation experience.
• 1+ year experience with fraud statutes and federal recoupment guidelines.
• Medical, dental, vision, and 401(k) plan participation.
• Unlimited vacation, paid parental leave, and paid wellness time.

About Oscar:

• Oscar is a health insurance company built on technology and member focus.
• We are an equal opportunity employer committed to diversity and inclusion.

Oscar Health

Oscar is a health insurance company built around a full-stack technology platform and focused on serving members. The company fosters an inclusive culture where employees can be their authentic selves, with a mission to change health care.