Medical Coding Analyst
Job Summary
To support process improvement initiatives, the remote Senior Analyst, Payment Integrity will leverage expertise in claims processing and medical coding to investigate issues, implement solutions, and enhance operational workflows within the Oscar claim environment.
Key responsibilities:
- Act as a subject matter expert on reimbursement policies and claims processing edits
- Research industry coding rules and collaborate with stakeholders to translate insights into actionable business requirements
- Identify and prioritize opportunities for improvement based on data analysis and partner feedback
Required qualifications:
- Bachelor's degree or 4+ years of relevant experience
- 4+ years of experience in claims processing, coding, auditing, or health care operations
- 3+ years of experience in medical coding within payment integrity
- Medical coding certification through AAPC or AHIMA
- Experience with reimbursement methodologies and claims processing practices
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