Business Project Lead Analyst – Payment Integrity

AnalystAnalystFull TimeRemoteSeniorTeam 10,001+Since 1982H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

29 days ago

Salary

$75.7K - $126.1K / year

Seniority

Senior

High School3 yrs expEnglish

Job Description

• Lead strategic collaboration between recovery vendors, providers, and internal network partners • Drive monthly provider and vendor discussions to review overpayment inventory • Partner with Network and Contracting teams to address uncooperative providers • Monitor vendor performance and accuracy, translating findings into corrective action plans • Serve as a subject matter expert on claim identification and recovery processes • Support client-driven and third-party audit initiatives by reviewing, analyzing, and reporting on recovery accuracy • Evaluate provider contract audit language and recommend enhancements • Analyze trends, exclusions, and provider behaviors to quantify financial impact • Develop and deliver clear, actionable reporting for leadership, providers, vendors, and external stakeholders • Enable vendor success through education on systems, procedures, and evolving recovery requirements

Job Requirements

  • High School Diploma or G.E.D. required
  • 3+ years of experience in payment integrity, provider relations, claims operations, or related healthcare analytics roles
  • 2+ years of hands-on experience with healthcare claim systems such as PROCLAIM and FACETS
  • Working knowledge of healthcare claim processing and recovery workflows
  • Experience partnering across matrixed teams including Network, Legal, Contracting, Sales, and Operations
  • Strong analytical and organizational skills
  • Demonstrated ability to manage complex issues with appropriate urgency and sound judgment
  • Proficiency in Microsoft Word and Excel

Benefits

  • Medical, vision, and dental health insurance
  • 401(k)
  • Company paid life insurance
  • Tuition reimbursement
  • Minimum of 18 days of paid time off per year
  • Paid holidays

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