Associate, Payment Integrity (Data Mining) jobs in United States
cer-icon
Apply on Employer Site
company-logo

Oscar Health · 17 hours ago

Associate, Payment Integrity (Data Mining)

Oscar Health is a health insurance company focused on serving its members through a technology platform. The Associate, Data Mining will ensure the smooth operation of payment integrity data mining programs and serve as a subject matter expert while facilitating vendor and internal programs.

Health CareHealth InsuranceInsuranceInsurTech
check
H1B Sponsor Likelynote

Responsibilities

Provide subject matter expertise and in-depth understanding of data mining workflows and program rules
Identify payment integrity solution issues that require action and provide steps needed to remediate the issue
Identify claims with post-payment errors and facilitate processes to recover payments and ensure future payment accuracy
Represent data mining payment integrity solutions in payment policy discussions and when necessary, document new policies or modifications to existing policies
Provide training and education to team members when necessary
Serve as a subject matter expert using internal and external tools in order to complete audits and provide guidance to team members
Serve as an in-house expert on data structure and visualization for various stakeholders in service operations
Facilitate quality review and validation of data mining concepts and overpayment identifications
Compliance with all applicable laws and regulations
Other duties as assigned

Qualification

Data mining solutionsClaims processingAuditingSQLCoding experienceHealth care operationsAnalytical skills

Required

3+ years of experience in claims processing, auditing or health care operations
3+ years of experience in building or supporting data mining payment integrity solutions
Proven ability to work independently to drive projects to completion
Some coding experience or database language exposure

Preferred

Bachelor's degree
3+ years of related work experience in analytics or operations
Experience with claims pricing algorithms and/or software
Experience using SQL

Benefits

Medical, dental, and vision benefits
11 paid holidays
Paid sick time
Paid parental leave
401(k) plan participation
Life and disability insurance
Paid wellness time and reimbursements

Company

Oscar Health

company-logo
Oscar is a health insurance company that offers individual and family plans, medicare advantages, and small group products.

H1B Sponsorship

Oscar Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (19)
2024 (24)
2023 (22)
2022 (36)
2021 (13)

Funding

Current Stage
Public Company
Total Funding
$1.99B
Key Investors
Tiger Global ManagementAlphabetFounders Fund
2025-09-16Post Ipo Debt· $355M
2021-03-03IPO
2020-12-17Private Equity· $140M

Leadership Team

leader-logo
Mark Bertolini
Chief Executive Officer
linkedin
leader-logo
Steven B. Kelmar
Executive Vice President & COS
linkedin
Company data provided by crunchbase