Claims Quality Audit Lead

Summary

Join Oscar's Claims Quality team as a Claims Quality Audit Lead! Ensure timely and accurate claims audits, serving as a subject matter expert for your team. Lead and coach a claims audit team, reporting findings to leadership. This blended work culture offers remote options or in-office work in NYC, Tempe, or Los Angeles. The role requires healthcare claims auditing experience and leadership skills. Competitive salary and benefits are offered, including medical, dental, vision, paid time off, 401k, and more.

Requirements

• 3+ years of experience in healthcare claims auditing
• 2+ year(s) ability to work independently to drive projects to completion
• Experience leading and coaching individual contributors

Responsibilities

• Provide subject matter expertise and in-depth understanding of Claims processing workflows
• Identify claims payment issues that require action through audit findings
• Represent claims quality in payment policy discussions and when necessary, document new policies or modifications to existing policies
• Provide training and education to team members
• Act as a subject matter expert using internal and external tools in order to complete audits and provide guidance to team members
• Responsible for quality measures within the audit team
• Mediates audit findings with key stakeholders
• Compliance with all applicable laws and regulations
• Other duties as assigned

Preferred Qualifications

• Bachelor’s degree
• Some coding experience or database language exposure
• 3+ years of related work experience in analytics or operations

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
• Annual performance bonuses
• Oscar’s unlimited vacation program