Certified Payment Integrity Analyst

Job Summary

A company is looking for a Payment Integrity Analyst (Remote).

Key Responsibilities

• Conducts research and analysis to identify and validate overpayment concepts and communicates findings to relevant teams
• Tracks and reports on cost avoidance and overpayment recovery concepts, resolving challenges and collaborating with cross-functional teams
• Reviews claims edit concept results for quality assurance and updates payment rules based on regulatory changes

Required Qualifications

• Bachelor's Degree in Health Information Management, Data Analytics, or equivalent work experience
• Certified Professional Coder required upon hire
• 3 years of relevant experience in healthcare claims reimbursement methodologies and data analysis
• Master's Degree in Health Administration, Information Systems, or related field preferred
• Knowledge of healthcare policies and proficiency in Microsoft Excel, Word, and Access