Oscar Health
Associate, Payment Integrity
$83K–$109K
Remote +1 · Remote · Full-time · Posted Oct 21, 2026
- Location
- Remote
Arizona, United States - Experience
- 4+ years in claims processing, coding, auditing, or health care operations; 4+ years in medical coding within payment integrity; 2+ years deriving insights from datasets; 1+ year improving workflows; 1+ year stakeholder collaboration. Preferred: 2+ years in a technical or process-improvement role.
- Education
- Bachelor’s degree or 4+ years of commensurate experience.
About the job
Supports payment-integrity process improvement and issue resolution by investigating claims, translating stakeholder concerns into actionable changes, and collaborating across teams.
What you'll do
- Provide expertise on claims-processing edits, reimbursement policies, and coding rules; respond to inquiries and disputes.
- Identify and prioritize payment-integrity opportunities, define business requirements, and work with partners to implement solutions.
- Research escalated issues, perform root-cause analysis, and keep stakeholders informed of progress.
What they ask for
- Bachelor’s degree or 4+ years of commensurate experience.
- 4+ years of experience in claims processing, coding, auditing, or health care operations, including 4+ years in medical coding within payment integrity.
- Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA).
- Experience with reimbursement methodologies, provider contract concepts, and claims processing/resolution practices; 2+ years deriving business insights from datasets and solving problems; 1+ year improving workflows and processes; and 1+ year collaborating with stakeholders.
Nice to have
- 2+ years in a technical or process-improvement role; Process Improvement or Lean Six Sigma training.
- Experience using SQL.
Pay
$82,717 - $108,566 per year (base salary)
Tools
SQL
AI focus
The posting refers to AI guidelines for candidate use and recruiting, but does not describe AI work in this role.
Model-written summary · the original posting is authoritative