Job Description
Hi, we're Oscar. We're hiring an Associate, Clinical Policy Coding to join our Clinical Policy team.
Oscar is the first health insurance company built around a full stack technology platform and a 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 You will be responsible for ensuring all clinical policy documents, initiatives, and projects have accurate, professional clinical coding.
You will report to the Senior Manager, Clinical Policy.
Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.
This is a hybrid role in our Tempe, Arizona office. You will work part of the time in the office and part of the time remote / work-from-home. #LI-Hybrid
Pay Transparency: The base pay for this role is: $72,720 - $95,445 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.
Responsibilities - Provide accurate code scoping for all clinical policies and initiatives within the Office of Clinical Affairs supporting policy maintenance, policy development, and policy compliance functions.
- Provide subject matter expertise on accuracy and adherence to coding guidelines, policies, and regulations.
- Research industry standard coding rules and provide input into clinical policy language and scope.
- Use knowledge gained through research and coding review to ideate opportunities. Translate into business requirements and collaborate with internal partners to effectuate change.
- Provide code scoping to a variety of projects on an ongoing basis.
- Compliance with all applicable laws and regulations
- Other duties as assigned
Qualifications - Bachelor's degree or 4+ years of commensurate work experience
- Certified Professional Coder (CPC) or similar designation through AAPC.
- 3+ years of coding experience working with ICD-10, CPT and HCPCS coding criteria and hierarchies.
- 1+ years experience collaborating with internal and/or external stakeholders to improve business workflows and processes.
Bonus points - Experience working in the healthcare insurance industry, specifically with medical coding guidelines and policies.
- Experience clinical policy regulatory compliance.
- Process Improvement or Lean Six Sigma training.
- Project management certification
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.
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.
Artificial Intelligence (AI) Guidelines : Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar.
California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Notice to Job Applicants.
Job Tags
Full time, Part time, Work experience placement, Work at office, Remote work,