COB Verification Specialist

<p data-pm-slice="1 3 []">Hi, we're Oscar. We're hiring a COB Verification Specialist to join our Payment Integrity team.</p> <p>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.</p> <p><strong>About the role:</strong></p> <p>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.</p> <p>You will report into the Manager, Payment Integrity.</p> <p><strong>Work Location: </strong>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. #LI-Remote</p> <p><strong>Pay Transparency: </strong>The base pay for this role is: $17.91 - $23.51 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.</p> <p><strong>Responsibilities:</strong></p> <ul> <li>Initiate the recovery process by conducting our reach to payers and providers on overpaid claims, and coordination with internal teams.</li> <li>Make outbound calls to providers to explain overpayment findings and resolve disputes. Escalate internally for additional support with provider questions, as needed.</li> <li>Maintain detailed records of all recovery activities, correspondence, and outcomes in Oscar's systems.</li> <li>Support leadership to scope, size, prioritize items and deliver solutions</li> <li>Compliance with all applicable laws and regulations</li> <li>Other duties as assigned</li> </ul> <p><strong>Requirements:</strong></p> <ul> <li>1+ years in health insurance claims, claims recovery, or a related field.</li> <li>Proficient in basic google sheets and/or excel</li> </ul> <p><strong>Bonus points:</strong></p> <ul> <li>Strong understanding of healthcare claims processing, medical billing, and insurance regulations (Medicare, Medicaid, commercial)</li> <li>Familiarity with provider contract terms and payment methodologies</li> <li>1+ years of related work experience in analytics or operations</li> <li>Strong understanding of healthcare claims processing, medical billing, and insurance regulations (Medicare, Medicaid, commercial)</li> </ul><div class="content-conclusion"><p><span style="font-weight: 400;">This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud</span><a href="http://hioscar.com/careers/recruitment-fraud-alert"><span style="font-weight: 400;"> </span><span style="font-weight: 400;">here</span></a><span style="font-weight: 400;">.&nbsp;</span></p> <p><span style="font-weight: 400;">At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.</span></p> <p><strong>Pay Transparency:&nbsp; </strong><span style="font-weight: 400;">Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. </span><span style="font-weight: 400;">Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.</span></p> <p><span style="font-weight: 400;"><strong>Artificial Intelligence (AI): </strong>Our <a href="http://hioscar.com/careers/ai-guidelines" target="_blank">AI Guidelines</a> outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.</span></p> <p><strong>Reasonable Accommodation: </strong><span style="font-weight: 400;">Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.</span></p> <p><span style="font-weight: 400;"><strong>California Residents:</strong> For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our <a href="https://www.hioscar.com/legal/privacy/">Privacy Policy</a>.</span></p></div>