Payment Integrity Analyst
Job Summary
Working remotely on a full-time basis, the Payment Integrity Analyst will perform detailed analysis to identify overpaid claims and recovery opportunities, support business initiatives through data analysis, and collaborate with various teams to optimize savings performance.
Key responsibilities
- Research, validate, and document overpaid claims and recovery opportunities through claims analysis and reimbursement review
- Monitor recovery concepts and claim outcomes, collaborating with multiple departments to investigate issues and enhance performance
- Support business initiatives by identifying implementation barriers and conducting user acceptance testing of new systems
Required qualifications
- Bachelor's degree in a related field or equivalent experience
- 2+ years of business process analysis experience, preferably in healthcare or claims payment/analysis
- Knowledge of managed care information systems and provider reimbursement methodologies
- Experience with medical coding and strong analytical skills
- Previous structured testing experience preferred
Complete Job Description
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