COB Specialist, Payment Integrity

Oscar Health

. Support Coordination of Benefits (COB) efforts for Payment Integrity .

Posted 11/11/2026full-timeRemote • United StatesMid-LevelSenior💰 $64,832 - $85,092 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Coordination of Benefits (COB) processes and methodologies, with a strong focus on payment integrity and claims analysis. Proven ability to enhance workflows, collaborate with stakeholders, and derive actionable insights from data.

Highest-signal resume keywords

Coordination Of BenefitsPayment IntegrityData AnalysisBusiness Workflow ImprovementStakeholder Collaboration

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingReimbursement MethodologiesRoot Cause AnalysisQuantitative AnalysisBusiness Insights Derivation

Soft Skills

CommunicationProblem-SolvingTraining

Industry Keywords

ComplianceClaims ResolutionPayment IssuesOscar Medical ClaimsCOB Audits

About the role

Key responsibilities & impact

Support Coordination of Benefits (COB) efforts for Payment Integrity
Investigate and verify proper payment of Oscar medical and pharmacy claims
Create new COB workflows, enhance existing workflows, and drive COB audits
Contribute as a subject matter expert for Oscar's COB reimbursement policies
Respond to internal and external inquiries and disputes regarding COB policies
Research claims and identify COB opportunities; translate findings into business requirements
Collaborate with internal and external partners to scope, prioritize, and deliver COB solutions
Identify thematic opportunities to solve COB problems
Keep stakeholders informed of progress, status changes, blockers, and completion
Provide research, root cause analysis, and training for escalated issues
Analyze, investigate, and confirm whether dual coverage exists for Oscar members
Use data analysis skills and tools to develop quantitative analyses of payment issues
Report to the Manager, Payment Integrity

Requirements

What you’ll need

A bachelor's degree or 4+ years of commensurate experience
4+ years of experience in payment integrity, ideally coordination of benefits
Experience with coordination of benefits reimbursement methodologies, provider contract concepts and common claims processing/resolution practices
2+ years experience deriving business insights from datasets and solving problems
1+ years experience improving business workflows and processes
1+ years experience collaborating with internal and/or external stakeholders
Compliance with all applicable laws and regulations

Benefits

Comp & perks

Employee benefits
Unlimited vacation program
Annual performance bonuses
Medical benefits
Dental benefits
Vision benefits
11 paid holidays
Paid sick time
Paid parental leave
401(k) plan participation
Life insurance
Disability insurance
Paid wellness time and reimbursements