Performance Integrity Analyst

Job Summary

Working remotely within Oregon, Washington, Idaho, or Utah, the full-time Performance Integrity Analyst will examine and validate performance metrics, audit claims and customer service activities, and provide feedback for quality improvement in alignment with established guidelines.

Key responsibilities

• Audit claims, enrollment, and customer service activities for accuracy and timeliness according to established policies
• Compile performance statistics and identify trends to support quality improvement initiatives
• Provide reports and feedback to management regarding departmental performance and service level goals

Required qualifications

• Four years of experience in Claims, Membership, or Customer Service, or equivalent education and experience
• Desirable audit experience
• Knowledge of claims coding, BlueCard, and customer service processes
• Familiarity with corporate software, such as Word, Excel, and Outlook
• Experience with AI tools and technologies to enhance productivity is highly desired