Hi, we're Oscar. We're hiring a Senior Specialist, Coding Auditor to join our Payment Integrity. 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: You will support issue resolution in the Oscar claim environment. You will be responsible for the end-to-end claims repayment quality, process improvement and supporting root cause analysis . You will report into the VP, Payment Integrity. Work Location: This is a remote position, open to candidates who reside in: Tempe, Arizona; Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; New York City, New York; Philadelphia, Pennsylvania; Salt Lake City, Utah. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role in New York City is: $65,412 - $85,853 per year. The base pay for this role in all other locations is: $58,870 - $77,267 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities: Develop and maintain a depth of expertise on CPT, HCPCS, and ICD-10 Coding guidelines and other insurance billing submission requirements. Requirements: 1+ years of coding or auditing experience across multiple specialties. Certified Professional Coder (CPC) designation or similar certification Bachelor's degree or 4+ years of work experience Experience working in health insurance specifically with claims processing, billing, reimbursement, or provider contracting. Bonus points: Certified Professional Medical Auditor Payment Integrity audit experience Demonstrated experience translating technical jargon to non-technical end users. Experience with HIPAA, data privacy, and/or data security processes Experience working with regulators governing (public or private) health insurance carriers This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here . 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 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.

Alinea is seeking highly-capable self-starters to join our audit team! Do you have an eye for detail, a razor-sharp wit, and experience in the 340B space? If so, we want to hear from you Position Summary The 340B Auditor conducts the audit process and collaborates with 340B Analysts and provider specialists while performing work steps evaluating components of the covered entity’s eligibility, program policies and procedures, qualification methods, purchasing practices, and OPAIS registration approach. The 340B Auditor also conducts routine internal audit activities for covered entities, purchasing reviews, and other related tasks as needed. Role and Responsibilities Conduct the 340B external audit process Engage clients by email in preparation for upcoming audits Provide client with instructions and explanations of data expectations Perform an audit kick-off call to understand the client’s 340B program Plan and set deadlines for the audit process Maintain a project management tracking board for each audit Routinely assess progress and communicate outstanding data elements Collaborate with 340B Analysts to complete audit work steps Evaluate audit work steps completed by 340B Analysts for completeness and accuracy Perform audit work steps and data analyses as needed Select appropriate targeted samples for the audit Conduct patient level testing of samples, evaluating each for diversion, or duplicate discount concerns Interview covered entity staff regarding their program operations Perform root cause analysis as to why diversion or duplicate discount may have occurred Provide education to client throughout the 340B audit process Suggest resources or changes to client internal audit process as appropriate Relay information regarding the current HRSA audit process and potential changes Request and evaluate follow-ups from the client as needed Collaborate with editing team to draft the 340B audit report Recommend appropriate corrective actions and assist client with implementation Communicate with consultants and managing partners regarding potential issues or outstanding data Maintain current 340B industry knowledge Conduct routine internal audits for covered entities as needed Assist covered entities in routine review of eligibility as needed Perform other 340B related tasks as needed Qualifications and Education Requirements/Preference Minimum Preferred Apexus 340B University Apexus ACE Certification High school diploma or GED equivalent Bachelors degree in related field Pharmacy experience Pharmacy degree or technician certification 3 years 340B experience Previous 340B program management Previous audit experience Preferred Skills and Knowledge 340B program knowledge Project management Leadership Team oversight Client relations Problem solving Time management Customer service Verbal and written communication Organization and planning Critical thinking Quality assessment Microsoft Excel Performance improvement Self-motivated Collaboration Pharmacy and purchasing knowledge Epic EMR Attention to detail TPA system settings Analytical skills Report writing Ability to work independently Salary and Benefits Salary is negotiable based on background, experience, employment status, and job duties. Benefits include full medical, pharmacy, dental, vision, life and disability insurance, unlimited vacation, sick leave, 401k match and annual bonus potential.

Resource Innovations is seeking a Commercial Energy Efficiency Market Engagement Lead to join our growing team in California. As a Commercial Energy Efficiency Market Engagement Lead with Resource Innovations, you will support our large commercial energy efficiency programs in California. The successful candidate will play a pivotal role in driving engagement initiatives, fostering strategic partnerships, and ensuring the successful implementation of energy efficiency measures within the healthcare, high tech, bio-tech and private school/college sectors. This position will provide market engagement support for a new energy efficiency program in and around the Los Angeles Metropolitan Area in California. The ideal candidate will reside in or around the greater Los Angeles Metropolitan Area, but other California-based remote locations will be considered. Some same day and/or overnight travel would be anticipated for customer meetings and client or program partner engagement. The ideal candidate possesses the right mix of organization, verbal and written communication skills, technical ability, and interpersonal skills to succeed in this position. In this role, you will collaborate with an existing project delivery team identifying and implementing energy efficiency projects with commercial customers, engage trade allies and program partners, drive participation, interface with utility clients and maximize energy savings to achieve program goals. Through consistent engagement with project developers both internal and external to RI, this role will seek to ensure balanced programmatic efforts amongst underrepresented areas or customer segments. Resource Innovations (RI) is a women-led energy transformation firm focused on impact . Building on our expertise in energy efficiency, we're constantly expanding our portfolio of clean energy solutions to guide utilities through increasingly complex, connected challenges. Load flexibility. Electrification. Carbon reduction. With every step, we're leading the charge to power change. Duties and Responsibilities Must be located in Southern California, preferably greater Los Angeles or willing to relocate Collaborate with Market Engagement Manager on outreach and coordination with customers Drive continued success with Program Partners Ensure compliance with existing Project Delivery Process Coordinate timely communications between all parties involved in Project Activity Host meetings with stakeholders and key decision makers Collaborate with internal and external project engineering teams Other duties as assigned. Requirements Benefits About Resource Innovations Resource Innovations (RI) is a women-led energy transformation firm focused on impact . Building on our expertise in energy efficiency, we’re constantly expanding our portfolio of clean energy solutions to guide utilities through increasingly complex, connected challenges. Load flexibility. Electrification. Carbon reduction. With every step, we’re leading the charge to power change. Resource Innovations is an Equal Opportunity Employer, committed to ensuring equal employment opportunities for all job applicants and employees without regard to race, color, religion, national origin, gender, age, disability, marital status, genetics, protected veteran status, sexual orientation, or any other protected status. In addition to federal law requirements, Resource Innovations complies with applicable state and local laws governing non-discrimination in employment in every location in which the company does work. Compensation & Benefits Resource Innovations offers competitive salaries based on a candidate's skills, experience and qualifications for the position.  The compensation range for the base salary for this position is $95,000-115,000.  In addition to base pay, employees are eligible for a discretionary annual bonus.  The stated salary represents the expected compensation for this position.  Final compensation will be determined based on factors such as the candidate's experience, education and location. We also offer a comprehensive benefits package that includes three weeks of paid vacation per year; paid holidays; a 401(k)-retirement plan with employer matching; health, dental and vision insurance; and other supplemental benefits. Employment with Resource Innovations is contingent upon the successful completion of a comprehensive background check and reference check. If applicable to the position, a pre-employment drug screen may also be required. The above job description and job requirements are not intended to be all inclusive. Resource Innovations retains the right to make changes or adjustments to job descriptions and/or job requirements at any time without notice.

• Audit coded charts assigned by quality supervisor per the client guidelines • Ability to move from different sets of client guidelines with minimal difficulty • Maintain a 95% quality average at a diagnosis level • Answer rebuttals entered on the auditor by coders and or auditors • Participate in weekly coding project review meetings • Any other tasks asked by quality supervisor