virtual vocationsNew York, NY
Payment Integrity Analyst
Payment Integrity Analyst
Payment Integrity Analyst
virtual vocationsNew York, NY
4 days ago
Claims Adjusters, Examiners, and InvestigatorsHealth Information Technologists and Medical RegistrarsHealth Informatics Specialists
Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension FundsDirect Health and Medical Insurance CarriersFinancial Transactions Processing, Reserve, and Clearinghouse Activities
Apply for this role (opens in a new tab)Working remotely on a full-time basis, the Payment Integrity Analyst will perform detailed analysis to identify overpaid claims and recovery opportunities, support business initiatives through data analysis, and collaborate with various teams to optimize savings performance.
Key responsibilities:
Research, validate, and document overpaid claims and recovery opportunities through claims analysis and reimbursement review
Monitor recovery concepts and claim outcomes, collaborating with multiple departments to investigate issues and enhance performance
Support business initiatives by identifying implementation barriers and conducting user acceptance testing of new systemsRequired qualificationsBachelor's degree in a related field or equivalent experience
2+ years of business process analysis experience, preferably in healthcare or claims payment/analysis
Knowledge of managed care information systems and provider reimbursement methodologies
Experience with medical coding and strong analytical skills
Previous structured testing experience preferred
Also on the board Same function, level within a rung
Level
Senior
Location
New York, NY
Occupation
Claims Adjusters, Examiners, and Investigators
Industry
Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds
Posted
4 days ago