Oscar

Oscar is a health insurance company that offers plans for individuals, families, and small businesses. With a focus on humanizing health care through technology, design, and data, Oscar provides easy-to-understand bills, 24/7 access to doctors, and a p...

Insurance

Financials

1K-5K (2714)

Founded 2012

18 open positions

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Senior Specialist, Coding Auditor

1 day, 2 hours ago

United States

Full-time

Junior

QA Engineer

Quality Assurance and Testing

HIPAA

Apply Now

Oscar

Insurance

1K-5K

Founded 2012

View All Jobs 18

Description

Develop expertise in CPT, HCPCS, ICD-10 coding guidelines and related insurance billing submission requirements.
Perform complex prepayment and post-payment audits of medical records and claims to assess claim accuracy.
Document audit findings clearly, including the sources used to support decisions, for both clinical and non-clinical audiences.
Create audit reports, tools, and reference guides to help teammates communicate findings and conduct similar reviews.
Draft written communications to providers explaining audit findings.
Participate in educational calls with providers.
Help train new team members.
Develop and document processes to improve team effectiveness.
Ensure compliance with all applicable laws and regulations.
Perform other duties as assigned.

Requirements

2+ years of coding or auditing experience across multiple specialties.
Bachelor's degree or 4+ years of work experience.
Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), or similar certification.
Experience working in a production-based environment.
Experience with both outpatient and inpatient auditing.
Must reside in Arizona, Florida, Georgia, or Texas.
Ability to work hybrid in-office at least two days per week if within commuting distance of the New York City, Tempe, or Los Angeles office.
Preferred: Certified Professional Medical Auditor (CPMA).
Preferred: Additional relevant certification such as CFE, AHFI, CAFP, or other coding certifications.
Preferred: Knowledge of fraud statutes, regulations, federal recoupment guidelines, and anti-FWA activity.
Preferred: Experience translating technical jargon for non-technical audiences.
Preferred: Experience in health insurance claims processing, billing, reimbursement, or provider contracting.
Preferred: Experience with HIPAA, data privacy, and/or data security processes.
Preferred: Experience working with regulators overseeing health insurance carriers.

Benefits

Base salary of $58,870 to $77,267 per year.
Eligibility for employee benefits.
Unlimited vacation program.
Annual performance bonuses.
Medical, dental, and vision coverage.
11 paid holidays.
Paid sick time.
Paid parental leave.
401(k) plan participation.
Life and disability insurance.
Paid wellness time and reimbursements.

Interested in this position?

Apply directly on the company website

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