Oscar Health: Itemized Bill Reviewer — Tempe, Arizona, United States

About Oscar Health

Oscar Health is a health-insurance business built around a technology platform and member services. Its recruitment board also describes Oscar Medical Group activities in virtual health assessments and virtual care. Those notices reflect distinct parts of the wider operation: insurance products and member administration alongside clinical services. Technology, insurance operations and care delivery consequently appear in different roles on the board, with the employing team determining the service and professional responsibilities of an individual position.

The position and its setting

Oscar Health lists Itemized Bill Reviewer in Tempe, Arizona, United States, under reference 8154911. The details below separate the work described by the employer from essential conditions, preferred experience and practical preparation advice.

• Department: Insurance Operations
• Employer listing date: 25 August 2026

Responsibilities and work described

• The Associate, Payment Integrity, Itemized Bill Review (IBR) will be responsible for executing internal payment integrity solutions requiring billing and coding expertise with and continual improvement and development of the solutions
• Quality / delivery: claims are paid accurately and timely with the highest quality
• This is accomplished by leveraging a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement
• Report into the Manager, Payment Integrity (Pre-Pay)
• Work: Location: This position is based in our Tempe, Arizona 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: $82,717 - $108,566 per year
• You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses
• Execution: line-by-line review of high-dollar facility itemized bills and corresponding claim forms (e.g., UB-04s)
• Proactively identify and document potential billing errors, including duplicate billing of items, services, or procedures as improper unbundling of services (e.g., separating components that should be billed together) and charges for non-covered or non-rendered services
• Compare billed charges against both payor-specific contracts and industry guidelines to confirm appropriate billing practices
• Apply working knowledge of national coding systems (e.g., CPT, HCPCS, ICD-10, MS-DRGs) to validate the accuracy of codes used for services billed
• Review: claims eligible under specific reimbursement scenarios: a percentage of charges or those exceeding stop-loss levels, ensuring the claim exceeds the minimum dollar threshold set by the payor
• Preparation: clear, concise, and professional documentation of all findings, including savings identified, policy violations, and recommended claim adjustments
• Contribution: to the refinement of internal audit processes and tools to enhance efficiency and accuracy in identifying claim inaccuracies
• Serve as a subject matter expert for internal and external stakeholders regarding complex billing issues, coding guidelines, and payor policies

Essential requirements and candidate background

• A bachelor's degree or 4+ years of commensurate experience
• 2+ years of bill / coding audit experience with a focus on hospital or facility billing (UB-04)
• 4+ years experience in medical coding
• Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA)
• Experience: reimbursement methodologies, provider contract concepts and common claims processing/resolution practices

Experience and professional background

• 3+ years of experience working with large data sets using excel or a database language

Preferred experience and additional strengths

• Knowledge management, training, or content development in operational settings
• Process Improvement or Lean Six Sigma training
• Experience using SQL
• This is an authentic Oscar Health job opportunity
• 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
• Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts
• 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 Privacy Policy

Location, schedule and contract conditions

For this overseas or regional listing, confirm work authorisation and any location restrictions with the employer. The location does not establish visa sponsorship or permission to work remotely from India.

• Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members
• We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family
• Advertised location: Tempe, Arizona, United States

Pay and application dates

A verified salary figure is not established in this article. An online estimate for another Itemized Bill Reviewer vacancy is not an offer for reference 8154911; use the employer’s own pay disclosure and recruitment communication.

A closing date is not confirmed in this article. Check the current employer page before submitting: an undated posting can change or be withdrawn.

How to apply to Oscar Health

Applications follow the official employer page linked below.

Open the official Oscar Health posting below and match the title and reference 8154911.

Compare your qualifications and experience with the essential conditions for the Tempe, Arizona, United States position, then read the preferred criteria separately.

Prepare an accurate CV and the supporting items requested in that employer’s application. Provide only information and documents you are authorised to share.

Use the employer’s application option, complete the required fields and review the submission. Retain the acknowledgement when one is provided. Job Alerts World does not receive the application.

Practical preparation: SQL

SQL references usually call for more detail than “database knowledge”. Explain the data you queried, the business or engineering question and how you checked that joins, aggregates and filters produced the intended result.

Relevant skills

• SQL
• AI/ML
• Excel
• AI
• process improvement
• Lean
• Six Sigma
• audit
• compliance