Claims Quality Control Analyst

Hi, we're Oscar. We're hiring a Claims Quality Control Analyst to join our Claims Operations team.

Oscar is the first health insurance company built around a full stack technology platform and a 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

The Claims Quality Control Analyst role is responsible for supporting process improvement and issue resolution in the Oscar claim environment for both the Oscar Insurance business and Oscar clients. This role is responsible for the end to end claims quality, process improvement and conducting root cause analysis

You will report to the Senior Manager, Payment Quality.

Work Location:

Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.

If you live within commutable distance to our New York City office ( in Hudson Square), our Tempe office (off the 101 at University Ave), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.

You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote

Pay Transparency:

The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $27.31 - $35.84 per hour. The base pay for this role in all other locations is: $24.58 - $32.26 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 10 days per year.

Responsibilities

• Analyze, investigate and approve claims data
• Support leadership to scope, size, prioritize items and deliver solutions
• Utilize data analysis skills and tools to develop accurate, quantitative analyses of issues.
• Mediate errors with key stakeholders
• Compliance with all applicable laws and regulations
• Other duties as assigned

Qualifications

• 2 years of experience in claims processing, auditing and health plan operations
• 1 years experience project work within claims operations
• 2 years of experience working with large data sets using excel or a database language

Bonus Points

• 2 years of related work experience in analytics or operations
• Experience with regulatory and third party claims audits