Payment Accuracy Specialist

Job Summary

A company is looking for a Payment Accuracy Specialist 2 to enhance healthcare payment integrity through audit processes.

Key Responsibilities

• Develop and execute audit concepts while training team members and evaluating audit effectiveness
• Conduct audits on client data to identify recoverable claims and ensure compliance with CMS and NAIC guidelines
• Collaborate with Engineering to improve audit tools and reporting, while maintaining productivity and quality standards

Required Qualifications

• High School Diploma required; Bachelor's degree preferred with 4-6 years of related healthcare experience
• 3-4 years of relevant experience within the company recommended for internal candidates
• Healthcare industry knowledge, including claim adjustments and reimbursement policies
• Proficiency in Microsoft Office and previous SQL experience strongly preferred
• Ability to work independently and in a team environment, demonstrating self-motivation