COB Verification Specialist

Job Description

Hi, we're Oscar. We're hiring a COB Verification Specialist to join our Payment Integrity team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

You will support issue resolution within the Oscar claims environment. This role is responsible for managing end-to-end member data and payer eligibility to ensure accurate and timely claims processing.

You will report into the Manager, Payment Integrity.

Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The base pay for this role is: $17.91 - $23.51 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

Requirements:

Bonus points:

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.

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• Initiate the recovery process by conducting our reach to payers and providers on overpaid claims, and coordination with internal teams.
• Make outbound calls to providers to explain overpayment findings and resolve disputes. Escalate internally for additional support with provider questions, as needed.
• Maintain detailed records of all recovery activities, correspondence, and outcomes in Oscar's systems.
• Support leadership to scope, size, prioritize items and deliver solutions
• Compliance with all applicable laws and regulations
• Other duties as assigned
• 1+ years in health insurance claims, claims recovery, or a related field.
• Proficient in basic google sheets and/or excel
• Strong understanding of healthcare claims processing, medical billing, and insurance regulations (Medicare, Medicaid, commercial)
• Familiarity with provider contract terms and payment methodologies
• 1+ years of related work experience in analytics or operations
• Strong understanding of healthcare claims processing, medical billing, and insurance regulations (Medicare, Medicaid, commercial)