COB Verification Specialist
About The Position
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 Senior 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.
Requirements
- 1+ years in health insurance claims, claims recovery, or a related field.
- Proficient in basic google sheets and/or excel
Nice To Haves
- 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)
Responsibilities
- 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
Benefits
- employee benefits
- monthly vacation accrual at a rate of 15 days per year
- medical, dental, and vision benefits
- 11 paid holidays
- paid sick time
- paid parental leave
- 401(k) plan participation
- life and disability insurance
- paid wellness time and reimbursements
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
