SIU Investigator, Analyst
Remote
Hi, we're Oscar. We're hiring a SIU Investigator, Sr. Analyst to join our SIU 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
The SIU Investigator (Senior Analyst) primary purpose is to investigate change in aberrant behavior observed in claims and enrollment data. You will work independently to analyze data, and manage investigative caseload from identification through to resolution including overpayment recovery, measuring behavior change and completing necessary reporting to meet monetary and case load targets through investigations and internal process improvementsā which should, at least initially, increase year-over-year ā for FWA recoupments and savings.
You will report to the Senior Investigator, SIU.
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 Ave), 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, 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: $76,800 - 91,200 per year. The base pay for this role in all other locations is: $69,120 - $82,080 per year. You are also eligible for employee benefits, participation in Oscarās unlimited vacation program and annual performance bonuses.
Responsibilities
- Identify and conduct investigations into known or suspected FWA with high autonomy
- Develop documentation to substantiate findings, including formal reports, graphs, audit logs, and other supporting documentation.
- Meet targets through investigations and internal process ā¦
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RestrictionsArizona California Colorado Connecticut Florida Georgia Illinois In-office requirement for local residents 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 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- Analyze data
- Conduct investigations
- Develop documentation
- Investigate fraud
- Manage caseload
- Process Improvements
- Reporting
Audit Billing C Claims processing Coding Data analysis Documentation Fraud detection Healthcare Health Insurance HIPAA Investigative Techniques Presentation Process Improvement Process improvements Provider Contracting Reporting Report Writing Root Cause Analysis Technology Technology Platform
Experience3 years
EducationBachelor's Bachelor's degree Criminal justice Related Field
CertificationsCertified fraud examiner Certified Professional Coder CFE CPC