Claims Processor

🔥 14 hours ago

🌵 Arizona, Florida, +2 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🤠 Texas – Remote 🍑 Georgia – Remote

💵 $20 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Oscar Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2012

⚕️ Healthcare Insurance

🏥 Healthcare

💰 $355M Post-IPO Debt - Oscar Health on 2025-09

Healthcare Insurance • Healthcare

Oscar Health is a technology-driven health insurance company that provides individual, family, and small-group health plans in multiple U. S. states. Oscar combines traditional insurance underwriting with digital-first services — a consumer-facing app, 24/7 virtual urgent care, prescription delivery (including $3 meds in many plans), and dedicated Care Teams — and also operates Oscar Primary Care in some markets. The company emphasizes accessible, affordable, high-quality care and uses AI to improve member experience and care delivery. Insurance policies are underwritten by Oscar's state insurance subsidiaries and the company offers both HMO and other plan types across its markets.

📋 Description

• Accurately and timely process health insurance claims • Research and process claims according to business regulations, internal standards, and processing guidelines • Resolve system edits, audits, and claims errors using approved references and investigative sources • Reduce daily inventory through claims processing • Contribute to team-wide goals supporting Claims Production daily operations • Comply with all applicable laws and regulations • Review eligibility, benefits, supporting documentation, coding, and payment guidelines • Identify discrepancies or potential issues for follow-up • Resolve claim inquiries and clarify claim status • Support prompt reimbursement • Perform other duties as assigned • Report to the Claims Lead

🎯 Requirements

• High School Diploma, GED or equivalent years of experience in data analytics, provider data and/or claims processing • Strong verbal and written communication skills • Ability to take direction and navigate through multiple systems simultaneously • Ability to solve problems within pre-defined methods and guidelines • Ability to review claims and analyze critical data • Experience with navigating claims resolution systems • Advanced Google Suite or Microsoft Office capabilities or willingness to learn • In-depth knowledge of Health Insurance operations processing protocols and payment schemes • Experience manipulating and entering accurate data in a production driven environment • Experience handling Personal Health Information (PHI) in a professional manner • Demonstrated capacity to balance competing priorities and continue to execute projects with excellence

🏖️ Benefits

• Monthly vacation accrual at a rate of 15 days per year • Medical, dental, and vision benefits • 11 paid holidays • Paid sick time • Paid parental leave • 401(k) plan participation • Life and disability insurance • Paid wellness time and reimbursements • Remote work from a home office • Occasional travel for team meetings and company events

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