COB Verification Specialist

Hi, we're Oscar. We're hiring a COB Verification Specialist to join our Payment Integrity team.

Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role:

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.

Pay Transparency: The base pay for this role is: $19.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

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

Requirements:

• 1+ years in health insurance claims, claims recovery, or a related field.


• Proficient in basic google sheets and/or excel

Bonus points:

• 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)