Healthcare Management Administrators

Healthcare Management Administrators is a professional benefit administrator located in Bellevue, Washington that offers a variety of health care products and s

Payment Integrity Analyst I

Location

Washington

Posted

3 days ago

Salary

$73K - $81K / year

Seniority

Senior

High School3 yrs expEnglish

Job Description

Payment Integrity Analyst I

Healthcare Management Administrators

• Provide strong analytical, problem-solving and quality assurance skills to support efficient, accurate and timely execution of assigned payment integrity programs • Combine healthcare knowledge and technical skills using programs including QicLink and Excel and reporting from vendor systems to gather, assess, and perform detailed evaluations of data to: • Identify issues, recommend solutions, and manage situations to resolution. • Identify, evaluate and deliver new program improvements that increase cost containment results for HMA and its clients. • Track, manage, and report on daily program inventory for short-term prioritization and long-term strategic planning. • Evaluate existing business processes and policies and develop sustainable, measurable improvements. • Produce clear written documentation to ensure consistent and accurate service provision, such as Procedural Work Instructions or Job Aids for core practices and business requirements for program changes. • Collaborate effectively with internal teams including Appeals, Claims, Client Success, and Stop Loss to deliver an informed, coordinated experience for clients and members. • Interact and communicate effectively with payment integrity program vendors and government agencies to meet program expectations. • Maintain current in knowledge of claims processing, job-related systems, and associated government regulations, and pursue education and training relevant to Payment Analyst role.

Job Requirements

  • High School Diploma required
  • ICD-10 & CPT experience required
  • 3-5+ year of claims processing experience within the insurance industry
  • 2+ year data entry experience
  • Intermediate Excel skills with the ability to build effective spreadsheets and manipulate data
  • Able to manage a complex daily queue and prioritize workload effectively
  • Skilled in identifying root causes of issues through detailed investigation and inquiry
  • Able to analyze impacts of potential actions or decisions to determine the optimal choice

Benefits

  • Seventeen (IC) days paid time off (individual contributors)
  • Twelve paid holidays
  • Two paid personal and one paid volunteer day
  • Company-subsidized medical, dental, vision, and prescription insurance
  • Company-paid disability, life, and AD&D insurances
  • Voluntary insurances
  • HSA and FSA pre-tax programs
  • 401(k)-retirement plan with company match
  • Annual $500 wellness incentive and a $600 wellness reimbursement
  • Remote work and continuing education reimbursements
  • Discount program
  • Parental leave
  • Up to $1,000 annual charitable giving match

Related Categories

Related Job Pages

More Analyst Jobs

Bristol Global Mobility logo

Expense Analyst Assistant – Corporate Relocation

Bristol Global Mobility

Improving the mobility experience, one connection at a time.

Analyst3 days ago
Full TimeRemoteTeam 51-200Since 1997H1B No Sponsor

• Review and audit expense transactions for accuracy, completeness, and compliance with company and client policies. • Process employee expense reports, vendor invoices, reimbursement requests, and other expense-related transactions. • Create vouchers and accurately enter financial transactions into expense management systems. • Process and reconcile monthly client American Express credit card charges and supporting documentation. • Research and resolve expense discrepancies, missing documentation, and payment issues. • Support month-end expense processing, reconciliations, and reporting activities. • Maintain accurate financial records and supporting documentation. • Identify opportunities to improve processes, strengthen controls, and increase operational efficiency. • Monitor and manage shared Expense Management department mailboxes. • Respond promptly and professionally to employee, client, and vendor inquiries. • Assist with reporting, data validation, and audit support. • Maintain and update process documentation and standard operating procedures.

Arizona
Full TimeRemoteTeam 11-50H1B No Sponsor

• Join Evio’s analytics team to work with both internal and external stakeholders to evaluate financial performance across a full medical medication rebate portfolio • Analyze medical rebate claims data using Evio’s proprietary, cutting-edge rebate administration platform to investigate invoicing variances, and ensure reporting accuracy for more than $500 million in annual rebates • Develop, prepare, maintain, and enhance analytics that provide insights into financial performance of medication rebate contracts • Support development of new analytics and technology that strengthen Evio’s evaluation of medical medication rebate programs • Identify opportunities to improve process and efficiency, and recommend innovative, data-driven solutions to Evio leadership • Facilitate data ingestion and standardization of critical medical medication rebate data extracts received from Blue Cross Blue Shield health plans • Work independently and efficiently, at times managing multiple priorities and asks

United States
$95K - $115K / year
Leidos logo

Aeronautical Information Analyst

Leidos

Leidos is an innovation company rapidly addressing the world’s most vexing challenges in national security and health.

Analyst3 days ago
Full TimeRemoteTeam 10,001+Since 1969H1B Sponsor

• Applying experience and comprehensive knowledge applicable to aeronautical studies in accordance with Title 14 Code of Federal Regulations (14 CFR), Part 77 notice criteria for construction or alteration of certain structures in the NAS • Review of construction proposals for completeness and accuracy • Evaluation of effects of proposed construction on the navigable airspace • Analysis of the cumulative effects of such proposals to minimize the impact to aviation while balancing the need for construction • Coordination of aeronautical information within established channels of communication and relationships both within and outside the FAA • Administrative extension requests • Terminating aeronautical studies when a structure has been demolished • Processing FAA Form 7460-2, Part I and/or Part II notifications • Coordinate with the project sponsor to either have them file electronically or input the data contained on the paper document into an electronic application • Assist first time obstruction evaluation filers through the process of filing an OE case using the external OE/AAA website • Research structures that are of concern to the public • Process FAA Form 7460-2, Part I and/or Part II notifications and generating Termination letters for non-responses to Project Status Reports (PSR) letters

Oklahoma
$65.7K - $118.7K / year
Sanchez & Sanchez Sociedade de Advogados logo

Mid-Level Software Development Analyst

Sanchez & Sanchez Sociedade de Advogados

Direito por experiência. Inovação por excelência.

Analyst3 days ago
Full TimeRemoteTeam 201-500Since 1998H1B No Sponsor

• Develop and design complex systems, identifying and specifying alternative hardware, software, and network infrastructure solutions. Possess broad technical knowledge in the area of expertise and detailed understanding of technical subjects, developing strategic solutions that accelerate adoption, migrations, application delivery, and internal infrastructure for high-performance, innovative digital solutions; • Participate in project management, enable and organize teams, prepare and monitor schedules, and perform quality analyses of results, providing agility in deliveries and contributing to organizational satisfaction; • Research new procedures, technologies, and equipment to apply innovation in system development for the organization and to implement Agile and Scrum methodologies.

Brazil