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 Senior 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: $19.00 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;">. </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: </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 ... (truncated, view full listing at source)