Associate, Clinical Policy Coding
Associate, Clinical Policy Coding
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Job Description
Hi were Oscar. Were 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 ourselvesone 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: This position is based in our Tempe AZ office requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events while your other two office days are flexible to suit your schedule. #LI-Hybrid
Pay Transparency:
The base pay for this role is: $72720 - $95445 per year. You are also eligible for employee benefits participation in Oscars 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
- Bachelors 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. Were 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 applicants disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () 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.
Required Experience:
IC
Employment Type
Full-Time
