State Licensed Payment Integrity Analyst

Job Summary

A company is looking for a Senior Analyst, Payment Integrity to join their Payment Integrity team.

Key Responsibilities

• Serve as a subject matter expert for reimbursement policies and claims processing edits
• Research industry coding rules and translate findings into actionable business requirements
• Collaborate with internal and external partners to identify and resolve adverse claim outcomes

Required Qualifications

• Bachelor's degree or 4+ years of relevant experience
• 3+ years of experience in claims processing, coding, or health care claims operations
• 3+ years of experience in medical coding within payment integrity
• Medical coding certification through AAPC or AHIMA
• Experience with reimbursement methodologies and claims processing practices