Utilization Review Processor

$39,520 - $39,520/Yr

Oscar Insurance Company

Full-time - Entry Level

Remote

Insurance Carriers and Related Activities

About the position

The Utilization Review Processor at Oscar will be responsible for addressing complex issues affecting providers and members. This role emphasizes providing exceptional service and ensuring a seamless member experience by identifying and resolving barriers to care. The position requires effective workload management and communication with various teams to enhance member and provider satisfaction.

Responsibilities

• Manage queue work and assigned caseload through efficient dashboard management
• Identify, investigate, and resolve issues within determined SLAs
• Collaborate with colleagues, Specialists, Experts, and Leads to identify trends and roadblocks
• Use internal tools and resources seamlessly
• Communicate findings and resolutions with providers and internal departments
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements

• 1+ years of customer support/service experience
• Advanced computer literacy skills with experience using CRM and knowledge management tools to resolve client issues
• Experience using ticket management and reporting tools
• Experience managing an assignment caseload
• Customer service experience
• Healthcare and/or SAAS experience

Benefits

• Medical, dental, and vision benefits
• 11 paid holidays
• Paid sick time
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance
• Paid wellness time and reimbursements