• Participate in regular deal reviews with the Team, stake holders, Sales and Sales Leadership to assess pricing, deal structuring, and overall account strategy. • Help drive decisions that align with both the client’s needs and the company’s objectives, ensuring timely deal closures. • Enforce pricing execution guidelines and collaborate with Sales Leadership on pricing, value positioning, and deal structure. • Ensure all necessary approvals are obtained for pricing, discounts, payment terms, and other critical elements. • Provide guidance to sales executives on alternative contract options, ensuring they have the knowledge and resources to expedite the approval process. • Serve as a key player in reducing deal approval times. Streamline processes, eliminate bottlenecks, and ensure all approvals (pricing, terms, structure) are handled efficiently to move deals quickly through the pipeline.

Role Description You are a person who loves to identify discrepancies, prevent overpayments, and ensure adherence to regulatory, contractual, and coding guidelines. We need someone who has expertise in medical coding, reimbursement methodologies, and healthcare policy and can apply that expertise to develop, implement, and maintain claims editing rules and audit processes. In the role of Payment Integrity Analyst, you will be responsible for ensuring the accuracy and compliance of healthcare claim payments across commercial, Medicare, and Medicaid lines of business. - Lead complex claim audits and investigations involving high-risk or high-value claims - Design, develop, and maintain advanced claims editing rules and logic - Translate complex regulatory and reimbursement policies into system specifications - Oversee testing, validation, and implementation of editing rules - Conduct root cause analysis and recommend systemic solutions - Monitor CMS, OIG, and regulatory updates; ensure organizational compliance - Act as SME for coding, billing, and payment integrity methodologies - Mentor junior analysts and provide technical guidance - Collaborate with IT, policy, and leadership teams on strategic initiatives - Support benefit configuration and optimization in platforms like TriZetto Facets - Present findings, insights, and recommendations to leadership Qualifications - Associate's or Bachelor's degree in Health Administration, Public Health, Business, or related field (or equivalent experience) - 5+ years of experience in healthcare claims, payment integrity, auditing, or revenue cycle - Advanced expertise in coding systems, reimbursement methodologies, and CMS regulations - Strong experience with claims editing platforms (e.g., Optum CES) - Advanced SQL and data analysis skills - Demonstrated experience in rule development and system configuration - Experience with Tricare and Veterans Administration, Medicare, Medicaid, and/or commercial reimbursement methodologies - Hands-on experience with claims adjudication and editing systems - Strong knowledge of CPT, HCPCS, ICD-10 coding systems - Proficiency in SQL and data analysis - Proficiency in Excel (pivot tables, VLOOKUP, data manipulation) - Experience with EDI transactions, CMS-1500, and claims workflows - One or more of the following: CPC (Certified Professional Coder), CCS / CCS-P (Certified Coding Specialist), RHIT / RHIA - Strategic thinking - Leadership and mentorship - Advanced analytical and technical skills - Deep regulatory and policy expertise - Strong decision-making and problem-solving ability Requirements - U.S. Citizenship or naturalized citizenship is required for this position. - All work on all positions at Signature Performance must be completed in the continental United States, Alaska, or Hawaii. Benefits - Health Insurance - Fully Paid Life Insurance - Fully Paid Short- & Long-Term Disability - Paid Vacation - Paid Sick Leave - Paid Holidays - Professional Development and Tuition Assistance Program - 401(k) Program with Employer Match

• Analyze claims and EMR data to evaluate program performance, including cost, utilization, and clinical outcomes • Support development of ROI analyses and performance reporting for clients and prospective clients • Build and maintain recurring and ad hoc analyses, ensuring accuracy and clarity of results • Translate business questions into structured analyses with guidance from the Director • Identify trends, outliers, and key drivers within healthcare data and clearly communicate findings • Partner with clinical, client success, and internal teams to support decision-making and continuous improvement • Contribute to the development and standardization of reporting, data processes, and analytical approaches • Prepare clear, concise summaries and presentations for internal and external stakeholders

• Execute components of OCM strategies, including stakeholder engagement, communications, and training plans • Conduct change impact assessments and stakeholder analyses with moderate guidance • Track, analyze, and report on adoption metrics, risks, and feedback • Identify gaps and recommend improvements to change approach • Own development of executive-ready PowerPoint presentations for leadership updates, steering committees, and program communications • Translate complex business, technical, or operational content into clear, structured, and visually compelling narratives • Design slides that effectively communicate key messages using frameworks, visuals, and data storytelling techniques • Elevate and standardize presentation quality across workstreams • Develop and manage internal communications (emails, announcements) aligned to the change strategy • Create high-quality deliverables such as job aids, FAQs, and quick reference guides • Partner directly with stakeholders and SMEs to shape messaging and ensure clarity and consistency • Design and develop training materials, including presentation decks and supporting resources • Support or facilitate training sessions and workshops as needed • Incorporate feedback and continuously improve training effectiveness