Clinical Investigator
Oscar Health
Location: Remote, United States (Remote)
Senior Analyst, Special Investigations Unit Clinical Investigator at Oscar Health (Remote) **What you'll do** - Detect and audit aberrant billing patterns within claims and clinical documentation - Perform comprehensive pre-payment and post-payment reviews of medical records - Analyze provider behavior to identify schemes invisible to automated systems - Translate audit findings into relevant education and facilitate professional discussions **What they're looking for** - Clinical expertise to identify fraudulent billing patterns - Ability to build evidentiary files for potential recovery or legal action - Strong analytical skills to review medical records and clinical documentation - Experience with CMS regulations and contractual obligations **Details** - Location: Remote (with potential hybrid requirements) - Type: Not specified - Salary: null
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