Become a Payment Integrity Professional 2 and leverage claims data, vendor platforms, and analytic tools to identify trends, perform root cause analysis, and develop mitigation strategies that support accurate payment outcomes.
Requirements
- Analyze medical claims data to identify trends, anomalies, and performance patterns related to code editing and payment accuracy
- Conduct root‐cause analysis on incorrect payment outcomes and develop actionable mitigation plans
- Support the review, testing, implementation, and maintenance of code edits, using data to validate expected outcomes
- Partner with internal stakeholders and external vendors to translate analytic findings into operational improvements
- Investigate and resolve code edit stakeholder inquiries through data research, issue analysis, and evidence‐based recommendations
- Monitor key performance metrics, identify operational risks, and proactively recommend improvements
- Drive process optimization and contribute to successful day‐to‐day operations
- Document findings, maintain reports, and communicate results to technical and non‐technical audiences
Benefits
- Generous Paid Time Off
- 401k Matching
- Tuition Reimbursement
- Generous Parental Leave
