Analyst, Payment Integrity (Data Mining)

Oscar Health • Tempe, AZ

2d • Hybrid

About The Position

The Data Mining Analyst is responsible for reviewing claims data to identify incorrect payments. The analyst supports payment integrity quality control for incorrect payments identified both internally and by vendors. You will report into the Senior Manager, Payment Integrity.

Requirements

• 2+ years of experience in healthcare
• 2+ years of experience working with large claims data sets using excel or a database language

Nice To Haves

• Some coding experience or database language exposure
• 2+ years of related work experience in payment integrity data mining
• Experience using SQL

Responsibilities

• Analyze and investigate claims data
• Support quality review claim and concept findings from internal and external partners regarding adverse claim outcomes.
• Utilize data analysis skills and tools to develop accurate, quantitative analyses of issues.
• Work with the team to identify thematic areas of opportunity to reduce incorrect payments.
• Mediate errors with key stakeholders
• Compliance with all applicable laws and regulations
• Other duties as assigned

Benefits

• medical
• dental
• vision benefits
• 11 paid holidays
• paid sick time
• paid parental leave
• 401(k) plan participation
• life and disability insurance
• paid wellness time and reimbursements

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed