Enrollment Processor (Eligibility)

Hi, we're Oscar. We're hiring an Enrollment Processor (Eligibility) to join our Eligibility & Billing team.

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.

About the role:

The E&B Production Processor is a volume-driven customer service and production based role that handles the day-to-day activities involved in running an Eligibility and Billing department at a health insurance company focused on completing back office tasks and addressing member questions in accordance with standard operating procedures.

You will report into the Associate Manager, Eligibility & Billing.

Work Location: This position is fully remote and open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming; and U.S. Territories. Daily work is completed from your home office, with occasional travel required for team meetings and company events. #LI-Remote

Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $18.31 - $24.03 per hour. The base pay for this role in all other locations is: $16.48 - $21.63 per hour. You are also eligible for employee benefits, monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

• Develop a comprehensive understanding of the current processes, procedures, tools, and regulations associated with the Oscar's enrollment and billing business model.
• Complete various enrollment and billing tasks through multiple channels according to departmental needs and assignments.
• Manage an assigned caseload while maintaining service delivery, productivity, and quality expectations
• Form working relationships with internal and external stakeholders.
• Support the leadership team by identifying issues through established escalation pathways
• Be accountable for monitoring and tracking the health of all assigned work-in-progress issues.
• Escalate and resolve issues to ensure appropriate turnaround times
• Be an active participant in process improvement initiatives
• Comply with all operational, regulatory, and compliance standards relating to member Personal Health Information (PHI)
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements:

• 1+ years of experience in administrative, customer service, data-entry, operations, healthcare, or insurance work
• High school diploma or GED
• Comfort using computers, multiple systems, and standard office tools
• Strong accuracy, attention to detail, and ability to follow written procedures
• Ability to handle confidential member information appropriately
• Clear written and verbal communication
• Ability to manage routine, deadline-driven work and meet productivity/quality expectations

Bonus points:

• Experience in health insurance, healthcare administration, or a regulated industry
• Exposure to claims, eligibility/enrollment, benefits, billing, provider data, prior authorization, or member records
• Experience working with high-volume queues
• Familiarity with HIPAA/privacy practices and documentation standards