Top Tech Jobs & Startup Jobs in Los Angeles, CA

The Provider Network Associate supports network accessibility, recruitment, and education functions while collaborating with internal and external partners to meet growth and quality targets.

The Associate supports process improvement and issue resolution in the claims environment, ensuring accurate and timely claims payments. They leverage industry knowledge to identify issues and collaborate with stakeholders for enhancements.

The Senior Specialist audits medical records and claims to assess FWA trends in healthcare, communicating findings, and training team members.

The Senior Analyst will improve processes and resolve issues related to payment integrity and claims for Oscar Insurance, leveraging knowledge to drive actionable improvements.

Perform line-by-line reviews of high-dollar facility itemized bills and claims (UB-04), identify billing/coding errors, validate codes (CPT, HCPCS, ICD-10, MS-DRG), compare charges to contracts and policies, document findings and recommended adjustments, refine audit processes, provide SME guidance and training, and collaborate cross-functionally to remediate payment integrity issues.

Manage and negotiate contracts with hospitals and large ancillary providers to build a high-performing network. Analyze provider performance and financial data, support national network strategy, ensure regulatory compliance, collaborate with provider services, and meet SLAs and cost-saving objectives.

Perform end-to-end claims coding audits and repayment quality reviews using CPT/HCPCS/ICD-10 guidelines; document findings, create reference guides, support provider communications, train teammates, and drive process improvements for payment integrity.

Partner with cross-functional teams to analyze large healthcare datasets, build models and dashboards, and surface insights to reduce medical waste. Scope, run, and present analyses, monitor performance metrics, and support initiatives to improve financial and utilization outcomes.