Payment Integrity Associate - Itemized Bill Review
Other
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WFA Digital Insight
In a booming health insurance market, demand for specialized professionals who can navigate complex billing and coding systems has skyrocketed. With the rise of tech-driven healthcare, companies like Oscar Health are at the forefront, seeking experts who can maintain the integrity of payments. As the shift to remote work continues, roles that require meticulous attention to detail and deep knowledge of healthcare infrastructure are increasingly valuable.
Job Description
About the Role
Oscar Health is seeking a Payment Integrity Associate to join their team, focusing on itemized bill review. The ideal candidate will have a deep understanding of healthcare billing and coding, as well as the ability to work cross-functionally to improve payment processes.Responsibilities
- Perform detailed reviews of high-dollar facility itemized bills and claim forms
- Identify and document potential billing errors, including duplicate billing and improper unbundling of services
- Compare billed charges against payor-specific contracts and industry guidelines to confirm appropriate billing practices
- Apply knowledge of national coding systems to validate the accuracy of codes used for services billed
Benefits
This role offers the opportunity to work with a cutting-edge health insurance company, with benefits including employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.How to Stand Out
- Develop a strong understanding of national coding systems, such as CPT, HCPCS, and ICD-10, to stand out in your application.
- Practice reviewing sample itemized bills to improve your attention to detail and ability to identify potential errors.
- Be prepared to discuss your experience with billing and coding software, as well as your ability to work in a remote environment.
- Consider highlighting any experience you have with data analysis and process improvement, as these skills are highly valued in this role.
- Prepare examples of times when you successfully identified and resolved billing errors or discrepancies, and be ready to discuss your approach to problem-solving.
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