Claims Processor

Hi, we're Oscar. We're hiring a Claims Processor to join our Claims Production 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

You will process incoming work associated with Claims operations following standard operating procedures.

You will report to the Claims Production Team Lead.

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. 

This is a remote / work-from-home role, however you must reside in Florida. #LI-Remote

Pay Transparency:

The base pay for this role is: $19.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 10 days per year

Responsibilities

• Develop an excellent grasp of the Administrative Operations system and overall workflows.
• Develop a comprehensive understanding of the current review processes that exist and additional processes needed to improve consistency and quality of review. 
• Contribute to the reduction of the daily inventory.
• Form relationships with all partners.
• Take ownership of monitoring, tracking, and providing a status on the health of all work-in-progress issues.
• Manage the escalation and resolution process with external vendors to ensure appropriate turnaround times (where applicable).
• Contribute to team-wide goals that support the success of Claims Productions daily operations.
• Compliance with all applicable laws and regulations 
• Other responsibilities as assigned

Qualifications

• 1+ years previous work experience in any of the following areas: data analytics, provider data, claims processing, broker commissions, eligibility and billing 
• 1+ years quantitative analysis skills demonstrated through the use of Excel or Google Sheets

Bonus Points

• A bachelor’s degree in Business, Accounting, Finance, Economics, Healthcare, Public Policy, Technology or Math
• In-depth knowledge of general Insurance or Health Insurance operations processing protocols and payment schemes.
• Experience manipulating and entering accurate data in a production environment.
• Experience handling Personal Health Information (PHI).
• Ability to balance competing priorities and continue to accomplish projects.