Job Summary
This position plays a vital role in enhancing payment integrity through the analysis and creation of post-payment recovery strategies and claims adjustments. The analyst will convert research outcomes into comprehensive business specifications that guide technical teams in implementation.
Responsibilities
- Research and develop concepts related to post-payment recovery.
- Create claims edits to optimize payment integrity processes.
- Translate analytical findings into detailed business requirements for technical teams.
Qualifications
- Minimum 2 years of experience in managed care or health insurance.
- Strong analytical and problem-solving capabilities.
- Proficient in medical coding and reimbursement methodologies.
- Preferred professional certifications in relevant fields.
