Payment Integrity Specialist

Job Summary

A company is looking for a Payment Integrity Data Mining/Recovery Specialist.

Key Responsibilities

• Collaborate with PI vendors and internal partners to mitigate future claim overpayments
• Analyze vendor files, manage overpayment adjustments, and reconcile PI vendor billing
• Conduct audits and outreach to recover overpayments and document recovery procedures

Required Qualifications

• High School Diploma or equivalent with three (3) years of experience in the health insurance field
• Ability to meet attendance and timeliness requirements
• Experience working in a team environment and building positive relationships
• One (1) year of experience in refund, Payment Integrity, and/or auditing is preferred