Enrollment Processor – Eligibility

This is a fully remote position, open to applicants in United States.

📋 Description

• Acquire a thorough understanding of the processes, procedures, tools, and regulations related to Oscar's enrollment and billing business model.

• Execute enrollment and billing tasks through various channels based on departmental requirements and assignments.

• Oversee an assigned caseload while ensuring service delivery, productivity, and quality standards are met.

• Build collaborative relationships with both internal and external stakeholders.

• Assist the leadership team by pinpointing issues through established escalation pathways.

• Monitor and track the status of assigned work-in-progress issues.

• Escalate and resolve issues to guarantee appropriate turnaround times.

• Engage in process improvement initiatives.

• Adhere to operational, regulatory, and compliance standards concerning member Personal Health Information (PHI).

• Follow all applicable laws and regulations.

• Carry out additional duties as assigned.

⛳️ Requirements

• Minimum of 1 year of experience in administrative roles, customer service, data entry, operations, healthcare, or insurance.

• High school diploma or GED is required.

• Proficiency with computers, multiple systems, and standard office tools.

• Exceptional accuracy, attention to detail, and the ability to adhere to written procedures.

• Capability to manage confidential member information responsibly.

• Effective written and verbal communication skills.

• Ability to manage routine, deadline-oriented tasks while meeting productivity and quality expectations.

• Experience in health insurance, healthcare administration, or a regulated industry is advantageous.

• Familiarity with claims, eligibility/enrollment, benefits, billing, provider data, prior authorization, or member records is a plus.

• Experience handling high-volume queues is a bonus.

• Knowledge of HIPAA/privacy practices and documentation standards is beneficial.

🏝️ Benefits

• Monthly vacation accrual at a rate of 15 days per year.

• Medical, dental, and vision coverage.

• 11 paid holidays.

• Paid sick leave.

• Paid parental leave.

• Participation in a 401(k) plan.

• Life and disability insurance.

• Paid wellness time and reimbursements.

• Ability to work fully remotely from a home office.

• Occasional travel for team meetings and company events.