Analyst, Payment Integrity (Data Mining)

Hi, we're Oscar. We're hiring an Analyst, Data Mining 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

The Data Mining Analyst is responsible for reviewing claims data to identify incorrect payments. The analyst supports payment integrity quality control for incorrect payments identified both internally and by vendors.

You will report into the Senior Manager, Payment Integrity

Work Location

This position is based in our New York City office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule.

Pay Transparency

The base pay for this role is: $28.26 - $37.10 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year

Responsibilities

Analyze and investigate claims data

Support quality review claim and concept findings from internal and external partners regarding adverse claim outcomes.

Utilize data analysis skills and tools to develop accurate, quantitative analyses of issues.

Work with the team to identify thematic areas of opportunity to reduce incorrect payments.

Mediate errors with key stakeholders

Compliance with all applicable laws and regulations

Other duties as assigned

Requirements

2+ years of experience in healthcare

2+ years of experience working with large claims data sets using excel or a database language

Bonus Points

Some coding experience or database language exposure

2+ years of related work experience in payment integrity data mining

Experience Using Sql

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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.

Artificial Intelligence (ai)

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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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