Remote Process improvement Jobs • Coding

The Senior Specialist, Payment Policy is responsible for supporting payment policy activities by investigating payment policy issues, leveraging understanding of Oscar's claim infrastructure, processing, and payment integrity to effectively improve and enhance payment policies. You will respond to inquiries, research industry coding rules, translate business requirements and identify opportunities to solve problems.

As a Payment Operations Associate at Maven, you will review and process complex claims related to Maven’s fertility treatments, procedures and applicable medications, and expenses related to additional paths to parenthood in accordance with company policies and benefits plan designs. You will also review claims to identify instances of denials and under payments.