Senior Manager, Revenue Cycle Management, Provider Operations

The posting, as Oscar Health wrote it

Hi, we're Oscar. We're hiring a Senior Manager, Revenue Cycle Management to join our Provider Operations 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 Senior Revenue Cycle Manager, Provider Operations is responsible for leading and optimizing revenue cycle operations across Oscar Medical Group. The role owns the development and execution of scalable revenue cycle strategies and processes that support accurate coding, compliant billing, timely reimbursement, and overall financial performance. This leader will serve as a subject matter expert in professional billing and coding and will partner closely with clinical, operations, finance, compliance, credentialing, product, to identify revenue cycle risks and opportunities and translate them into actionable operational strategies.

The Senior Manager will establish performance standards, controls, reporting, and workflows across the revenue cycle while using data and root-cause analysis to drive measurable improvements in revenue capture, claims performance, coding accuracy, and provider documentation. This role will also provide strategic guidance to OMG leadership on revenue cycle performance, risks, and opportunities as the organization grows and evolves.

You will report into the Director, Clinical Operations.

Work Location: This is a remote position, open to candidates who reside in: Dallas, TX. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The base pay for this role is: $122,212 - $160,404 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Responsibilities

• Own the strategy and performance of OMG's revenue cycle function, including professional billing, coding, claims management, denials, eligibility, documentation, and related workflows.
• Serve as the senior subject matter expert for coding and billing, including CPT, ICD-10-CM, HCPCS, modifiers, CCI/NCCI edits, and payer requirements.
• Establish and monitor revenue cycle KPIs and controls, using data and root-cause analysis to improve clean claims, coding accuracy, reimbursement, denial rates, and overall financial performance.
• Lead coding and documentation integrity strategies, including pre- and post-bill review, provider queries, addendums, signatures/co-signatures, identification of inappropriate documentation practices or cloning, and proactive provider education to address documentation gaps and support accurate coding.
• Lead denial prevention and resolution strategies, identifying systemic trends and pa

[…]
perience working within both provider and payer environments, providing an understanding of revenue cycle from both perspectives.

• Experience with risk-adjustment coding, including ICD-10/HCC documentation and coding practices.
• Experience with credentialing and payer enrollment processes and their downstream impact on revenue cycle performance.
• Experience managing external revenue cycle, coding, or billing vendors.

This is an authentic Oscar Health job opportunity.

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.

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