Florida Licensed Payment Integrity Analyst

Job Summary

To support the PACE program administration, the full-time remote Florida Licensed Payment Integrity Analyst will provide quality and operational support, including claims auditing, data analysis, issue resolution, and process improvement initiatives.

Key responsibilities

• Analyze and resolve operational issues related to claims, provider networks, and benefits
• Act as a liaison between internal departments and external partners to ensure efficient operations
• Create reports and analyses to support business decisions and ensure compliance with regulations

Required qualifications

• Bachelor's degree in healthcare administration, business, or related field, or equivalent work experience
• 4+ years of experience in a claims healthcare environment or health insurance
• Proficient in Microsoft Excel and experienced with data tools and reporting software
• Strong analytical skills with a focus on problem-solving
• Ability to work independently and collaboratively in a fast-paced environment