Interview Studio

Requirements found

Training (nice) Compliance Excel (nice) Sql (nice) Recruiting (nice)

What this posting asks for

Level: Mid level — The posting asks for 4+ years of experience.

Main responsibilities

• Work Location: This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneap…
• Pay Transparency: The base pay for this role is: $64,832 - $85,092 per year. You are also eligible for employee benefits, participation in Oscar's unlimited …
• Contribute as a subject matter expert for Oscars COB reimbursement policies
• Respond to internal and external inquiries and disputes regarding COB policies
• Use knowledge gained through research and claims review to ideate COB opportunities. Translate into business requirements; submit to and collaborate with int…
• Ingest information from internal and external partners regarding adverse claim outcomes; collaborate with partners to scope, size, prioritize items and deliv…
• Use insights from partner submissions, process monitoring, etc., work with the team to proactively identify thematic areas of opportunity to solve COB problems.
• Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field q…
• Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated and assigned by leadership.
• Analyze, investigate and confirm if dual coverage exists for Oscar membership

Competencies an interviewer will look for

• Problem solving Core
  In the posting: “This role is responsible for investigating and verifying proper payment of Oscar medical and pharmacy claims.” · “Use insights from partner submissions, process monitoring, etc., work with the team to proactively identify thematic areas of opportunity to solve COB problems.” · “Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc.”
  Show it by: Describes a real problem, the options considered and the one chosen; Shows how the cause was found, not just the fix.
• Teamwork and collaboration Core
  In the posting: “submit to and collaborate with internal partners to effectuate change.” · “collaborate with partners to scope, size, prioritize items and deliver COB solutions.” · “Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.;”
  Show it by: Says what they did inside a team, not only what 'we' did; Shows how a disagreement was handled.
• Planning and organisation Core
  In the posting: “collaborate with partners to scope, size, prioritize items and deliver COB solutions.” · “Experience in a professional healthcare claims organization” · “Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) …”
  Show it by: Shows how priorities were set when everything was urgent; Mentions deadlines met and how.
• Data and analysis Core
  In the posting: “Use insights from partner submissions, process monitoring, etc., work with the team to proactively identify thematic areas of opportunity to solve COB problems.” · “Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc.” · “Analyze, investigate and confirm if dual coverage exists for Oscar membership”
  Show it by: Uses a number to describe the situation or the result; Explains what the data showed and what was done with it.
• Stakeholder management Core
  In the posting: “submit to and collaborate with internal partners to effectuate change.” · “Ingest information from internal and external partners regarding adverse claim outcomes;” · “collaborate with partners to scope, size, prioritize items and deliver COB solutions.”
  Show it by: Shows how they aligned people with different goals; Explains how they handled a 'no' from someone senior.
• Attention to detail and quality Core
  In the posting: “Utilize data analysis skills and tools to develop accurate, quantitative analyses of payment issues” · “Compliance with all applicable laws and regulations”
  Show it by: Gives an example of an error caught before it caused harm; Names the check or standard they used.
• Technical skill Supporting
  In the posting: “2+ years of experience working with large data sets using excel or a database language, preferably SQL.”
  Show it by: Names the tools, languages or systems used and how; Explains a technical choice and its trade-off.
• Leadership and mentoring Supporting
  In the posting: “whenever issues are escalated and assigned by leadership.”
  Show it by: Describes setting direction or a standard others followed; Names someone they coached and what changed for them.
• Adaptability and learning Supporting
  In the posting: “however, our approach to work may adapt over time.”
  Show it by: Describes learning something new quickly and using it; Shows a change of plan and how they adjusted.

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