Remote opportunity at
OSCAR ASSOCIATES (AMERICAS), LLCItemized Bill Reviewer
OSCAR ASSOCIATES (AMERICAS), LLC is hiring a full-time Itemized Bill Reviewer for its Payment Integrity team. Founded in 2012, the company operates as a health insurance…
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About This Role
OSCAR ASSOCIATES (AMERICAS), LLC is hiring a full-time Itemized Bill Reviewer for its Payment Integrity team. Founded in 2012, the company operates as a health insurance provider built on a full-stack technology platform. This fully remote position is open to candidates residing in the United States, excluding Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and U.S. territories. The role requires daily work from a home office,…
Job Description
OSCAR ASSOCIATES (AMERICAS), LLC is hiring a full-time Itemized Bill Reviewer for its Payment Integrity team. Founded in 2012, the company operates as a health insurance provider built on a full-stack technology platform. This fully remote position is open to candidates residing in the United States, excluding Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and U.S. territories. The role requires daily work from a home office, alongside occasional travel for company events and team meetings.
The Itemized Bill Reviewer executes internal payment integrity solutions to guarantee claims are handled accurately, timely, and with high quality. Responsibilities include line-by-line evaluations of facility itemized bills, uncovering billing discrepancies, analyzing coding accuracy, and collaborating with cross-functional teams to resolve workflow friction. Base pay ranges from $91,908 to $120,629 per year in California, Connecticut, New Jersey, New York, and Washington, and $82,717 to $108,566 per year in all other permitted locations. Full-time workers are eligible for employee benefits, unlimited vacation, performance bonuses, medical, dental, and vision coverage, paid time off, and retirement plan participation.
Responsibilities
- Conduct line-by-line analyses of high-dollar facility itemized bills and related claim forms like UB-04s
- Spot and document potential billing mistakes such as duplicate charges, improper unbundling, and non-rendered services
- Evaluate billed charges against payor contracts and industry standards
- Confirm the correctness of billing codes using national systems including CPT, HCPCS, ICD-10, and MS-DRGs
- Assess claims meeting specific reimbursement scenarios like percentage of charges or stop-loss thresholds
- Produce clear documentation regarding findings, identified savings, policy breaches, and recommended adjustments
- Act as a subject matter expert for internal and external groups on complex billing topics and coding rules
- Identify claims processing issues through data mining and process monitoring to scope remediation steps
- Formulate business requirements based on coding rules and collaborate with internal partners to implement changes
- Support leadership objectives by conducting research, root-cause analysis, and team training
Requirements
- Possess a bachelor’s degree or 4 or more years of commensurate experience
- Have at least 2 years of bill or coding audit experience concentrating on hospital or facility billing
- Accumulate 4 or more years of background in medical coding
- Hold a medical coding certification through AAPC or AHIMA
- Demonstrate familiarity with reimbursement methodologies, provider contract concepts, and claims processing practices
Qualifications
- Bring 3 or more years of background working with large data sets via Excel or a database language
- Demonstrate knowledge management, training, or content development experience in operational environments
- Show completion of Process Improvement or Lean Six Sigma training
- Display practical experience utilizing SQL
Core Skills
Benefits
- Participation in an unlimited vacation program
- Annual performance bonuses
- 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
Frequently Asked Questions
Answers are based only on the employer’s listing; where it doesn’t say, neither do we.
Is this position remote?
Yes, this is a fully remote role where daily work is completed from a home office, though occasional travel for team meetings and company events is required. It is open to candidates in the U.S. except for Alaska, Delaware, Hawaii, Louisiana, Montana, North Dakota, Oklahoma, West Virginia, Wyoming, and U.S. territories.
What is the salary range for the Itemized Bill Reviewer role?
The base pay in California, Connecticut, New Jersey, New York, and Washington ranges from $91,908 to $120,629 per year. In all other eligible locations, the base pay is $82,717 to $108,566 per year.
What are the core experience requirements for applicants?
Applicants must have a bachelor’s degree or at least 4 years of commensurate experience, 2 or more years of bill or coding audit experience focused on hospital or facility billing, 4 or more years in medical coding, a medical coding certification through AAPC or AHIMA, and experience with reimbursement methodologies and provider contract concepts.
What benefits are provided for this full-time job?
Full-time employees are eligible for employee benefits including medical, dental, and vision coverage, participation in an unlimited vacation program, annual performance bonuses, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.
Sample Interview Questions
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