Payment Integrity Analyst - Claims & Audit Expert

IEHP; Rancho Cucamonga (CA); On-site; USD 80,000 - 106,000; Full time

Benefits offered by this job

Competitive salary

On-site fitness center

Medical insurance

Life insurance

Career advancement

Wellness programs

Flexible Spending Account

CalPERS retirement

457(b) matching

Paid life insurance

Pet care insurance

Job summary

IEHP in Rancho Cucamonga is seeking a Payment Integrity Analyst to use data analytics and regulatory expertise in monitoring overpayment inventory. This role involves collaborating with various teams to identify discrepancies and implement solutions to enhance payment accuracy.

The ideal candidate will have a Bachelor's degree in healthcare or finance, along with 3+ years of relevant experience. The position offers competitive salary and comprehensive benefits.

Qualifications

• 3+ years of experience in healthcare claims processing, billing, or auditing.
• Experience with interpreting contracts and financial responsibilities.
• Strong understanding of medical coding and health insurance contracts.

Responsibilities

• Monitor overpayment inventory and perform claims analysis.
• Collaborate with cross-functional teams to detect inaccuracies.
• Support operational improvements to enhance payment accuracy.

Skills

Data analysis

Medical coding

SQL

Problem-solving

Communication

Trend analysis

Organizational skills

Education

Bachelor's degree in healthcare or finance

Relevant certifications (RHIA, RHIT, etc.)

Tools

Microsoft Office Suite

Job description

IEHP in Rancho Cucamonga is seeking a Payment Integrity Analyst to use data analytics and regulatory expertise in monitoring overpayment inventory. This role involves collaborating with various teams to identify discrepancies and implement solutions to enhance payment accuracy.

The ideal candidate will have a Bachelor's degree in healthcare or finance, along with 3+ years of relevant experience. The position offers competitive salary and comprehensive benefits.