Payment Integrity Specialist
6 days ago
Job Summary
The Payment Integrity and Reimbursement Analyst plays a critical role in enhancing claim outcomes across existing and emerging product lines within the Network Services organization. This position is responsible for orchestrating collaborative efforts with cross-functional teams to devise and implement project strategies, mitigate risks, monitor progress, lead process optimization endeavors, and create transformative change.
Key Responsibilities
- Oversee and manage the enhancement of claim outcomes across existing and emerging product lines
- Collaborate with cross-functional teams to devise and implement project strategies
- Mitigate risks and monitor progress
- Lead process optimization endeavors and create transformative change
- Develop a strategic roadmap to recover, eliminate, and prevent unnecessary medical-expense spending
- Support the execution of a comprehensive claim accuracy program
Requirements
- Bachelor's degree required; Master's degree preferred
- Minimum of five years of progressive experience in the healthcare industry
- Minimum of three years of applicable experience in Payment Integrity and Reimbursement
- Minimum of five years of applicable experience with health insurance preferred
Work Schedule
Monday-Friday, Day Shift; 80 hours/2 weeks
Pay
The hourly range for this position is $43.50 per hour, dependent on experience.
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