This role is responsible for supporting process improvement and dispute resolution in the Oscar payment integrity environment. The Specialist reviews, investigates, and resolves provider disputes related to claims, payments, contract terms, etc. This is accomplished by leveraging a deep understanding of Oscar’s claim and payment integrity infrastructure.

The CDI (Clinical Documentation Improvement) Manager oversees the supervision of CDI staff, establishing and maintaining metrics and performance goals, collaborating with clinicians and coders, and developing policies and procedures. Additional responsibilities include establishing work assignments, priorities and focus, supervision of CDI staff, and maintaining program metrics and performance goals.

Under limited supervision, Trauma Registrar is responsible for reviewing applicable documentation and assigning appropriate procedure and diagnosis codes. Assign ICD 10 CM and ICD 10 PCS codes by interpreting clinical data for reimbursement, planning, management, and statistical analysis in various data models. Evaluate the quality and integrity of the clinical documentation to identify incomplete or inconsistent documentation for encounters that affect the codes selection and payments.