Claims Processor

Summary

Join Oscar's Claims Production team as a Claims Processor! This remote role, based in Texas, offers a competitive hourly rate of $19.00 and a comprehensive benefits package. You will process incoming claims work, adhering to standard operating procedures. Responsibilities include developing a strong understanding of operational systems and workflows, contributing to inventory reduction, and managing issue resolution. The ideal candidate possesses 1+ years of experience in data analytics, claims processing, or related fields, along with strong quantitative analysis skills. A bachelor's degree and in-depth insurance knowledge are considered bonus points.

Requirements

• 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

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

Preferred Qualifications

• 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

Benefits

• 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
• Monthly vacation accrual at a rate of 10 days per year