EI
Payment Integrity Analyst
Expert In Recruitment Solutions
🇺🇸 United States
On-site
5 months ago
- CMS
- medical coding
- DRG
5 months ago
Job Title: Payment Integrity Analyst
Location: Remote. Work EST
Top Skills Required:
Reimbursement Policies and CMS Medicare & Medicaid guidelines
Industry trends on the policies and coding guidelines
Medical Coding - coding audits, DRG audits, COB audits, itemized bill reviews
Analyzing medical claim trends
Analyzing Post-Payment Audit Outcomes
Analyzing Provider Reimbursement policy trends
Identify Payment Integrity Risk and Improvement Opportunities
The Payment Integrity Analyst – Post Payment Audits, Claims Analytics & Reimbursement Policy Strategy is responsible for independently analyzing medical claims trends, post payment audit outcomes, and industry-wide provider reimbursement policy trends to identify payment integrity risks and improvement opportunities. This role combines hands-on claims analytics with external market intelligence, requiring the ability to evaluate evolving reimbursement practices across the industry and recommend applicable policies that improve payment accuracy, compliance, and financial integrity.
Payment Integrity Analyst · Expert In Recruitment Solutions