COB Verification Specialist

Remotemid

Other

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Quick Summary

Key Responsibilities

Initiate the recovery process by conducting our reach to payers and providers on overpaid claims, and coordination with internal teams.

Requirements Summary

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,

Technical Tools

Other

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

~1 min read

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 Manager, Payment Integrity.

Responsibilities

~1 min read

→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 min read

1+ years in health insurance claims, claims recovery, or a related field.
Proficient in basic google sheets and/or excel

Nice to Have

~2 min read

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)

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

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.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. 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.

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Reasonable Accommodation: 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.

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