Member & Provider Care Specialist at Oscar Health

You are a customer support professional with at least one year of experience handling escalations in healthcare or a fast-paced tech environment. You possess a

Work type: remote

Location: Florida, United States

Salary: $22/hr

Type: Full-time

Summary

You are a customer support professional with at least one year of experience handling escalations in healthcare or a fast-paced tech environment. You possess a high school diploma or GED and thrive in environments where you solve complex member and provider issues. **What makes it worth a look...** Oscar Health offers a flat rate of $22 per hour for this fully remote role, provided you live in Arizona, Florida, Georgia, or Texas. You also receive 15 days of vacation per year. **You might be a good fit if you...** * Have at least one year of specific experience managing escalations. * Carry a background in customer support, healthcare, or technical operations. * Demonstrate proficiency with case management dashboards and knowledge base systems. * Possess optional experience with insurance claims or fluency in Spanish.

Job Description

Hi, we're Oscar. We're hiring a Care Specialist to join our Member & Provider Escalations team.

Oscar is the first health insurance company built around a full stack technology platform and a 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

You will solve complex issues or concerns impacting our providers and the members they serve. You will be a subject matter expert for Member and Provider Services. You will be a liaison between production teams and optimization/strategy teams. You will assist with internal questions and training support and communicate with our Members and Providers. You will contribute to the tracking and reporting of network issues and are a key contributor to our knowledge management system. You will ensure workflows are complete and up to date while also managing a queue of assigned cases.

You will report into Member Escalations Operations Manager.

Work Location:This is a remote role.You must reside in Arizona, Florida, Georgia, or Texas.Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. #LI-Remote

Pay Transparency:

The set rate for this role is $22.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

### Responsibilities

• Handle inbound and outbound calls, secure messages and/or email communications with members or providers

• Manage queue work and and assigned caseload through efficient dashboard management

• Identify, investigate, and resolve issues within determined SLAs

• Collaborate with colleagues, Experts, and Leads to identify trends and roadblocks

• Utilize internal tools and resources seamlessly

• Effectively communicates findings and resolutions with providers and internal departments

• Support Member and Provider Services Representatives with complex issues, workflows, and training

• Escalate updates or incorrect information in the internal knowledge management system for Member and Provider Services

• Partner with production teams across the LifeCycles to improve the member and provider experience

• Compliance with all applicable laws and regulations

• Other duties as assigned

• 1+ years in customer support, healthcare, tech and/or related field

• Experience in a fast-paced environment

• 6 + months of member and customer service experience

• 1+ year of escalations experience in a customer service environment

• 1 + years of claims experience

• Bilingual Spanish

• Bachelor's degree

• High school diploma or GED

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.

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