Member & Provider Care Specialist

🔥 0 minutes ago

🌵 Arizona, Florida, +1 more states – Remote

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

💵 $22 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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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

• Solve complex issues or concerns impacting providers and the members they serve • Serve as a subject matter expert for Member and Provider Services • Liaise between production teams and optimization/strategy teams • Assist with internal questions and training support • Communicate with members and providers • Contribute to tracking and reporting of network issues • Contribute to the knowledge management system • Ensure workflows are complete and up to date • Manage a queue of assigned cases • Handle inbound and outbound calls, secure messages, and/or email communications • Manage queue work and assigned caseload through dashboard management • Identify, investigate, and resolve issues within determined SLAs • Collaborate with colleagues, Experts, and Leads to identify trends and roadblocks • Utilize internal tools and resources • Communicate findings and resolutions with providers and internal departments • Support Member and Provider Services Representatives with complex issues, workflows, and training • Escalate updates or incorrect information in the internal knowledge management system • Partner with production teams across the LifeCycles to improve the member and provider experience • Comply with all applicable laws and regulations • Perform other duties as assigned

🎯 Requirements

• 1+ years in customer support, healthcare, tech and/or related field • Experience in a fast-paced environment • 6+ months of member and customer service experience • 1+ year of escalations experience in a customer service environment • 1+ years of claims experience (bonus points) • Bilingual Spanish (bonus points)

🏖️ Benefits

• Employee benefits • Monthly vacation accrual at a rate of 15 days per year • Medical benefits • Dental benefits • Vision benefits • 11 paid holidays • Paid sick time • Paid parental leave • 401(k) plan participation • Life insurance • Disability insurance • Paid wellness time and reimbursements