Senior Payment Integrity Specialist

Job Summary

A company is looking for a Sr. Payment Integrity Specialist - Coordination of Benefits.

Key Responsibilities

• Lead investigations to validate insurance coverage and resolve eligibility conflicts
• Perform outreach and documentation to confirm coverage information and update records
• Analyze data to identify trends and recommend process improvements for accuracy

Required Qualifications

• Minimum of eight (8) years of healthcare experience related to COB or payment integrity
• Experience in conducting COB investigations and managing complex case inventories
• Advanced proficiency with Excel and ability to analyze large data sets
• Knowledge of COB rules and primary/secondary payer logic
• Ability to work independently while meeting productivity and quality metrics