---
title: 'Associate, Payment Integrity IBR at Oscar Health'
canonical: 'https://feeny.ai/job/associate-payment-integrity-ibr-oscar-health-tempe-arizona-5m5h6jmc1wra'
type: 'job'
last_seen: '2026-09-10'
---

# Associate, Payment Integrity IBR at Oscar Health

- **Company:** Oscar Health
- **Location:** Tempe Arizona, United States
- **Posted:** 2026-08-24
- **Last confirmed live:** 2026-09-10
- **Apply:** http://www.hioscar.com/careers/8154911?gh_jid=8154911

## Job description

Hi, we're Oscar. We're hiring an Associate, Itemized Bill Review to join our Payment Integrity 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 Associate, Payment Integrity, Itemized Bill Review (IBR) will be responsible for executing internal payment integrity solutions requiring billing and coding expertise with and continual improvement and development of the solutions. You will ensure claims are paid accurately and timely with the highest quality. This is accomplished by leveraging a deep understanding of Oscar's claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement.

You will report into the Manager, Payment Integrity (Pre-Pay).

Work Location: This position is based in our Tempe, Arizona office, requiring a hybrid work schedule with 3 days of in-office work per week. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. #LI-Hybrid

Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.

Responsibilities:

- Perform line-by-line review of high-dollar facility itemized bills and corresponding claim forms (e.g., UB-04s)
- Proactively identify and document potential billing errors, including duplicate billing of items, services, or procedures as improper unbundling of services (e.g., separating components that should be billed together) and charges for non-covered or non-rendered services
- Compare billed charges against both payor-specific contracts and industry guidelines to confirm appropriate billing practices.
- Apply working knowledge of national coding systems (e.g., CPT, HCPCS, ICD-10, MS-DRGs) to validate the accuracy of codes used for services billed.
- Review claims eligible under specific reimbursement scenarios: a percentage of charges or those exceeding stop-loss levels, ensuring the claim exceeds the minimum dollar threshold set by the payor
- Prepare clear, concise, and professional documentation of all findings, including savings identified, policy violations, and recommended claim adjustments
- Contribute to the refinement of internal audit processes and tools to enhance efficiency and accuracy in identifying claim inaccuracies
- Serve as a subject matter expert for internal and external stakeholders regarding complex billing issues, coding guidelines, and payor policies
- Provide subject matter expertise and in-depth understanding of Payment Integrity internal claims processing edits, external vendor edits and Oscar reimbursement policies
- Identify claims payment issues from data mining, process monitoring, etc., provide scoping and action steps needed to remediate the issue
- Respond to internal and external inquiries and disputes regarding policies and edits.
- Document industry standard coding rules and provide recommendations on reimbursement policy language and scope
- Ideate payment integrity opportunities based on a deep knowledge of industry standard coding rules. Translate into business requirements; submit to and collaborate with internal partners to effectuate change
- Provide training and education to team members when necessary
- Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate
- Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated and assigned by leadership
- Compliance with all applicable laws and regulations
- Other duties as assigned

Requirements:

- A bachelor's degree or 4+ years of commensurate experience
- 2+ years of bill / coding audit experience with a focus on hospital or facility billing (UB-04)
- 4+ years experience in medical coding
- Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA)
- Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices

Bonus points:

- 3+ years of experience working with large data sets using excel or a database language
- Knowledge management, training, or content development in operational settings
- Process Improvement or Lean Six Sigma training
- Experience using SQL

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud[here](http://hioscar.com/careers/recruitment-fraud-alert).

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](http://hioscar.com/careers/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](https://www.hioscar.com/legal/privacy/).

## About Oscar Health

## Company Overview
- **One-liner**: Oscar Health is a healthcare technology company that builds a full-stack health insurance platform to make high-quality, affordable healthcare accessible for individuals, families, and employers.
- **Entity Type**: Public (NYSE: OSCR)
- **Headquarters**: New York City, USA (TriBeCa)
- **Founded**: 2012
- **Founders**: Mario Schlosser (CTO & Co-Founder); additional co-founders are not publicly detailed in the provided sources.

## Core Business
- **Primary industry**: Health insurance / healthcare technology
- **Target customers**: B2C (individuals, families, Medicare beneficiaries) and B2B (employers through Small Group plans and ICHRA)
- **Mission**: “Make a healthier life accessible and affordable for all.”

## Products & Services
- **Oscar Individual & Family Plans** – Health insurance sold on- and off-exchange, featuring $0 virtual urgent care, $3 generic medications, and dedicated Care Teams.
- **Medicare Advantage** – Medicare health plans launched in 2020, available in select states.
- **Oscar for Employers (Small Group / ICHRA)** – Employer-sponsored health benefits, including Individual Coverage Health Reimbursement Arrangements (ICHRA).
- **Oscar Provider Platform** – A technology platform that connects providers with Oscar’s member engagement tools.
- **Oscar App & Care Router** – Digital engagement platform that routes members to appropriate care (virtual or in-person) and enables 24/7 communication with a Care Team.

## Market Standing
- **Valuation/Market Cap**: Not directly provided in the search results; as a public company, market cap is available via SEC filings (e.g., ~$6B as of recent market data, but not confirmed in these sources).
- **Key Metric**: Serves approximately 1.6 million members as of August 2024 (the company also reports a figure of ~3.2 million members, possibly including additional plan types or a different measurement).
- **Notable Investors/Partners**: Not specified in the provided search results; the company went public in 2021 and counts major venture firms among its early investors.
- **Growth Signals**: Active in 20 states; member base grew from 1 million in 2022 to over 1.6 million; launched Medicare Advantage in 2020; has 238 active job postings as of the search date, indicating expansion.

## Competitive Advantages
- **Full-stack technology platform** – Oscar owns the entire insurance stack (claims, care management, provider network), enabling data-driven personalization and member engagement.
- **High member trust and engagement** – 68% of members trust Oscar for care guidance; 44% are digitally engaged; Net Promoter Score of 66; 76% have interacted with digital or Care Team channels.
- **Care Team model** – Every member is assigned a dedicated Care Team that coordinates care, reduces costs, and improves outcomes.
- **Virtual care integration** – $0 virtual urgent care with 97% member satisfaction; virtual primary care in some markets.

## Strategic Focus
- **Geographic expansion** – Entering new states and markets, including Medicare Advantage.
- **AI and technology** – Actively investing in AI to improve care routing, cost savings, and member experience (see “AI @ Oscar” page).
- **Provider platform growth** – Scaling the Oscar Provider Platform to partner with independent providers and health systems.
- **Employer market** – Expanding ICHRA and Small Group offerings to reach more businesses.

## Why Work Here
- **Mission-driven culture** – “Change healthcare for good” with a focus on making insurance simple, transparent, and human. Values include transparency, grit, scientific thinking, and “members above all.”
- **Comprehensive benefits** – Health insurance (obviously), 10+ weeks of parental leave, wellness days, fitness classes, mental health support, 401(k) plan, HSAs, and learning & development programs.
- **Offices** – Headquarters in New York City (TriBeCa), plus offices in Los Angeles (Silicon Beach) and Tempe, Arizona (Health Hub). Remote/hybrid policy not explicitly stated, but many roles appear location-flexible.
- **Growth opportunity** – With 238 open positions and recent member growth, employees can work on challenging problems at scale.
- **Diverse and inclusive environment** – Publishes a diversity report and emphasizes belonging; employees describe culture as collaborative and high-impact.

## Sources
1. [hioscar.com/about](https://www.hioscar.com/about)
2. [hioscar.com/careers](https://www.hioscar.com/careers)
3. [hioscar.com/careers/life](https://www.hioscar.com/careers/life)
4. [linkedin.com/company/oscar-health](https://www.linkedin.com/company/oscar-health)
5. [hioscar.com](https://www.hioscar.com/)

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