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Optimizing Our Claims Ops

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She cut her teeth in the non-profit world, and built her career in energy startups. Now, she’s solving problems and driving innovative operations in complex technical processes. Meet Karen, Oscar’s Manager of Claims Operations.

Tell us a little about your background. What were you doing before Oscar?

I had started my career in the non-profit world and spent time working for organizations in Africa and New York. But right before coming to Oscar, I was helping to build a start-up in the energy and environment industry. We spent a lot of time thinking about how to automate manual processes and help our clients engage with complex energy data.

How did you first connect with Oscar?

I had a friend who had started working at Oscar long before I did, and his stories about the ‘new kind of health insurance’ they were creating made me think about that industry in a new way. I’ve always been connected to and loved mission-driven organizations, especially in the start-up world. So it was just a matter of time before I asked my friend to connect me to this role, and to the recruiters here at Oscar.

What were some of your early projects like?

Early on, I spent most of my time learning about the complex ecosystem of claims processing, documenting opportunities for us to streamline and improve our operations, and thinking about how to measure our performance so we could focus on the right operational improvements. I also wore a lot of hats problem-solving and helping to clarify claims-related questions that came up from our members and providers. We care a lot about the experience our members and providers are having, so it’s a constant balancing act of meeting the needs of the individual and making sure we’re driving improvements on the whole system.

And what about more recently?

What’s really exciting to me is that we’ve been able to implement a lot more improvement projects lately and are really seeing that progress reflected in our metrics. Lately, I’ve been focused on setting up our claims operations in new states and planning for growth.

How would you describe your colleagues?

I came to Oscar because I knew the people I would be working with were very smart and accomplished in a variety of fields. I was excited to learn from them and be challenged to grow in new areas, and this has definitely proved to be true. My colleagues are a unique blend of intelligent, accomplished, and fun. Everyone here is focused on the true mission and heart of what Oscar is trying to do.

And life at the company, overall?

What makes Oscar unique is that we really do care about the product we’re building and the members we’re serving. We want to make things work better. This is felt in all areas of the company and really drives life at Oscar, which is a lot of fun. When people [outside of Oscar] describe their feelings on health insurance, I often smile to myself knowing that they certainly don’t mean this crazy, passionate, and innovative bunch of people. We’re definitely not what you would expect out of a health insurance company. 


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