Clinical Investigator, SIU

Oscar Health(10 days ago)

RemoteFull TimeSenior$64,832 - $85,092Special Investigations Unit

About this role

Oscar is hiring a Senior Analyst, Special Investigations Unit Clinical Investigator who is responsible for detecting and auditing suspicious billing activities to ensure compliance with healthcare regulations and guidelines, utilizing forensic clinical expertise. The role involves reviewing medical records, analyzing provider behaviors, and collaborating with teams to promote billing accuracy and compliance.

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Required Skills

Clinical Auditing
Medical Review
Forensic Expertise
Claims Processing
Provider Education
Medical Coding
Regulatory Compliance
Data Analysis
Healthcare Regulations
Healthcare Fraud

About Oscar Health

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Oscar Health is a technology-driven health insurance company offering individual, family, and Medicare plans in select U.S. markets. It pairs insurance coverage with consumer-focused digital tools — a mobile app, telemedicine, and dedicated care teams — to simplify enrollment, care navigation, and claims management. Using data and provider partnerships, Oscar emphasizes preventive care, personalized support, and greater cost transparency for members.

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