Enrollment Processor (Eligibility)

Oscar Health
United States
RemoteCareer-pivot friendly

Who this role is best for

Geared toward candidates comfortable with handling high-volume enrollment and billing tasks, and working in a remote setup with occasional travel.

Best fit for

  • Candidates with administrative or customer service experience in healthcare or insurance
    — “1+ years of experience in administrative, customer service, data-entry, operations, healthcare, or insurance work”
  • Individuals who can manage routine, deadline-driven work with precision
    — “Ability to manage routine, deadline-driven work and meet productivity/quality expectations”
  • People who thrive in a remote environment and can build relationships with stakeholders
    — “Form working relationships with internal and external stakeholders”

Things to consider

  • Candidates must be eligible to work in the U.S., excluding several states and territories
    — “open to candidates residing in the U.S., excluding Alaska; Delaware; Hawaii; Louisiana; Montana; North Dakota; Oklahoma; West Virginia; Wyoming”
  • This role involves handling sensitive member information and requires strict compliance
    — “Comply with all operational, regulatory, and compliance standards relating to member Personal Health Information (PHI)”
  • Occasional travel is expected for team meetings and company events
    — “occasional travel required for team meetings and company events”

How to stand out

  • Emphasize prior experience with high-volume queues and process improvement in your resume
    — “Experience working with high-volume queues”
  • Highlight your ability to follow written procedures and maintain accuracy
    — “Strong accuracy, attention to detail, and ability to follow written procedures”
  • Showcase your familiarity with HIPAA/privacy practices in your application materials
    — “Familiarity with HIPAA/privacy practices and documentation standards”
  • Demonstrate your communication skills with examples of handling member inquiries
    — “Clear written and verbal communication”
  • Include examples of managing caseloads and meeting productivity expectations
    — “Manage an assigned caseload while maintaining service delivery, productivity, and quality expectations”
Pace · SteadyCollaboration · LowAutonomy · MediumDecision Impact · Individual

Derived from job-description analysis by Serendipath's career intelligence engine.

What success looks like

  • 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
Typical background
1+ years of experience in administrative, customer service, data-entry, operations, healthcare, or insurance work

Skills & requirements

Required

Volume-driven Customer Service And ProductionBack Office TasksAddressing Member QuestionsCompleting Back Office TasksHandling Member Questions

Preferred

Experience In Health Insurance, Healthcare Administration, Or A Regulated IndustryFamiliarity With Hipaa/privacy Practices And Documentation Standards

About the role

Original posting from Oscar Health via Greenhouse

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

This is an authentic Oscar Health job opportunity.

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. We're 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.

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.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

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.

Source: Oscar Health careers (Greenhouse)

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