Senior Claims Quality Control Analyst
Remote
Hi, we're Oscar. We're hiring a Senior Claims Quality Control Analyst to join our Total Quality Management team.
Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesāone that behaves like a doctor in the family.
About the role
You will support process improvement and issue resolution in the Oscar claim environment for both the Oscar Insurance business and +Oscar clients. You will organize, scopes, triages, investigates and/or executes on solutions and process improvements. This is accomplished by leveraging an understanding of Oscarās claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement
You will report to the Associate Audit Lead.
Work Location:Ā
Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.Ā
If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role.Ā Ā
You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote
Pay Transparency:
The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $72,800 - $95,550 per year. The base pay for this role in all other locations is: $65,520 - $85,995 per year. You are also eligible for employee benefits, participation in Oscarās unlimited vacation program and annual performance bonuses.
Responsibilities
- Ingest information from internal and external partners regarding adverse claim outcomes; collaborate with partners to scope, size, prioritize items and deliver solutions.
- Utilize data analysis skills and tools to develop accurate, quantitative analyses of issues. ā¦
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RestrictionsArizona California Colorado Connecticut Florida Georgia Illinois Iowa Kentucky Maine Maryland Massachusetts Michigan Minnesota Missouri Must reside in one of the following states Must reside in specified states Nevada New Hampshire New Jersey New Mexico New York North Carolina Ohio Oregon Pennsylvania Rhode Island South Carolina Tennessee Texas Utah Vermont Virginia Washington
Benefits/Perks11 paid holidays 401k plan participation Annual performance bonuses Dental Disability Insurance Employee benefits Life and Disability insurance Medical Medical, dental, and vision benefits Paid holidays Paid parental leave Paid sick time Paid wellness time Paid wellness time and reimbursements Performance bonuses Unlimited Vacation Unlimited vacation program Vision Vision Benefits
Tasks- Collaborate with partners
- Collaboration
- Compliance
- Compliance with all applicable laws and regulations
- Data Analysis
- Identify opportunities for improvement
- Issue resolution
- Other duties as assigned
- Process Improvement
- Process Improvements
- Support process improvement
- Training
Analysis Audit Auditing Business Insights C Claims Claims processing Collaboration Compliance Consulting Cross-functional Collaboration Data analysis Data Mining Education Engineering Excel Finance Healthcare Healthcare Claims Healthcare operations Health Insurance Infrastructure Leadership Lean Lean Six Sigma Management Models Monitoring Operations Process Improvement Process improvements Quality Management Root Cause Analysis Six Sigma SQL Technology Technology Platform Total quality management Training Workflow Management
Experience3 years
Education Certifications