Healthcare Payment Integrity Analytics Specialist

Blue Cross and Blue Shield of Louisiana Inc.; Baton Rouge (LA); On-site; USD 80,000 - 110,000; Full time

Job summary

Blue Cross and Blue Shield of Louisiana is seeking a Payment Integrity Analyst to provide advanced technical, analytical, and financial support for Payment Integrity programs in Louisiana. You will analyze and reconcile payments, invoices, and related financial data to ensure accuracy and regulatory compliance.

The role requires strong Excel skills, data analysis ability, and experience with SQL. You will work in a fast-paced environment, collaborating with internal and external stakeholders to

Qualifications

• Bachelor's degree in Healthcare, Finance, Accounting, Business Administration, or a related field; 4 years of related experience may substitute for a degree.
• 2 years of healthcare industry experience in Financial analysis, Payment integrity or reimbursement analysis, Provider contract analysis, Internal audit, or Value-based care programs
• 1 year of experience solving complex business, financial, or clinical problems through data analysis
• Experience performing financial reconciliations involving payments, invoices, billing activity, and General Ledger transactions
• Strong analytical, mathematical, and problem-solving skills with attention to detail and accuracy
• Excellent written and verbal communication skills, including presenting findings to leadership
• Advanced proficiency with Microsoft Excel and Microsoft Office applications
• Ability to analyze, interpret, reconcile, and summarize large volumes of financial and operational data
• Ability to work independently in a fast-paced, deadline-driven environment

Responsibilities

• Analyze and reconcile Payment Integrity program payments, billings, vendor invoices, and related financial transactions for accuracy and compliance
• Validate vendor invoices and payments against contractual terms, expected savings, and program performance metrics
• Perform financial analysis, variance reporting, cost savings validation, and performance monitoring for Payment Integrity initiatives
• Identify discrepancies, conduct root cause analyses, and partner with stakeholders to resolve issues and improve processes
• Develop methodologies, reports, and data-driven recommendations to support operational efficiency and financial stewardship
• Serve as a subject matter expert for Payment Integrity data supporting audits, compliance, and cross-functional initiatives

Skills

Advanced Excel

Data analysis

SQL

Communication

Education

Bachelor's degree

Tools

SQL

Job description

Blue Cross and Blue Shield of Louisiana is seeking a Payment Integrity Analyst to provide advanced technical, analytical, and financial support for Payment Integrity programs in Louisiana. You will analyze and reconcile payments, invoices, and related financial data to ensure accuracy and regulatory compliance.

The role requires strong Excel skills, data analysis ability, and experience with SQL. You will work in a fast-paced environment, collaborating with internal and external stakeholders to