Senior Analyst, Claims Production

As a Senior Analyst in Claims Production at Oscar, your key responsibilities include managing and resolving complex claims issues, collaborating with internal partners to translate findings into actionable business requirements, and implementing process improvements. You'll also be expected to analyze data and identify opportunities for operational efficiency, ensuring a seamless experience for our members.

To qualify for the Senior Analyst position in Claims Production at Oscar, candidates should have a bachelor’s degree or four years of relevant health plan experience, along with at least three years working in healthcare claims organization. Proficiency with large data sets and root-cause analysis is also required, alongside skills in collaborating with stakeholders and improving business processes.

Oscar is committed to the professional growth of its employees, particularly in the Senior Analyst position. You will have access to ongoing training and development opportunities, including process improvement initiatives and potential bonuses for high performance. This dedication to employee growth helps foster a culture of continuous learning and improvement.

Yes! The Senior Analyst, Claims Production role at Oscar is primarily remote. However, if you are located within commuting distance to one of our offices, you'll be expected to come in at least two days a week. This flexibility is part of our blended work culture, designed to keep you connected with the team while enjoying the benefits of remote work.

At Oscar, the company culture is designed to be inclusive, supportive, and collaborative. As a Senior Analyst, you will be part of a team that values transparency and teamwork. We promote an environment where everyone's voice is heard, and diverse perspectives are celebrated, which helps us achieve our mission of transforming health care.

When resolving complex claims issues, I first gather all relevant information from internal and external partners. I then analyze the data to identify root causes before developing comprehensive solutions. Effective communication is key, so I ensure to keep stakeholders informed throughout the process.

I approach data analysis by first identifying the key metrics needed to answer business questions. I work with large data sets and use tools like Excel to transform the data into understandable formats. I focus on finding trends and insights that lead to actionable recommendations for process improvements.

In previous roles, I've frequently collaborated with cross-functional teams by facilitating meetings to ensure all perspectives are considered. I appreciate the varied expertise different departments offer, and I strive to build strong relationships to enhance teamwork and achieve our shared objectives.

I utilize a combination of Lean Six Sigma principles and data-driven strategies to identify waste in processes. Once I define a problem area, I work with stakeholders to brainstorm improvements, pilot changes, and monitor results to ensure sustained performance enhancements.

To ensure compliance, I stay informed about applicable laws and regulations by attending training sessions and reading relevant updates. I regularly consult with compliance teams to guarantee that our processes and outcomes align with regulatory standards and best practices.

One challenging experience involved a high volume of adverse claim outcomes. By analyzing the patterns and root causes, I identified the key issues. I then collaborated with stakeholders to design an improved process that led to a significant reduction in errors and enhanced member satisfaction.

I prioritize tasks by assessing the impact and urgency of each project. I use project management tools to create a visual overview, which helps me allocate resources effectively and meet key milestones while keeping communication open with all stakeholders.

I value feedback as a crucial part of personal and professional growth. I make it a point to listen actively, ask clarifying questions, and implement constructive suggestions into my workflow. By viewing feedback as an opportunity, I foster an open dialogue with stakeholders.

I prefer using Excel for its versatility and powerful functions, but I also enjoy using BigQuery for handling large datasets. The ability to perform complex queries in BigQuery saves time and allows me to extract actionable insights quickly.

Success in the Senior Analyst role at Oscar means driving measurable improvements in claims processing and operational efficiencies while enriching the member experience. Achieving a culture of collaboration and transparency while delivering strategic solutions is my ultimate goal.