Provider Relations Operations Associate

Neara; Northern (KY); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive compensation package

Medical, Dental and Vision benefits

Flexible, paid vacation policy

Direct access to Leadership

Job summary

Alaffia Health is seeking a Payment Integrity Operations Associate to own the audit lifecycle from document requests to final findings, ensuring timely, compliant outcomes. You will collaborate with clinical reviewers, audit managers, and product teams to maintain smooth provider experiences and efficient audit throughput.

The role requires 4+ years in healthcare operations, strong communication, and excellent organizational skills.

Qualifications

• 4+ years in healthcare operations or audit support.
• Excellent written and verbal communication skills.
• Highly organized with multiple concurrent workflows.
• Detail-oriented with accuracy in documentation and data entry.

Responsibilities

• Own the audit lifecycle: track cases from document request to final finding and ensure deadlines.
• Send and follow up on documentation requests and obtain medical records as needed.
• Manage the provider inbox: triage requests and respond within turnaround times.
• Compose and send audit finding letters with clear, accurate outcomes.
• Identify workflow gaps and update SOPs to improve consistency and throughput.
• Maintain organized documentation and audit traceability in internal systems.
• Collaborate cross-functionally with clinical auditors and product teams to resolve issues.
• Deliver a high-touch provider experience balancing compliance with empathy.

Skills

Communication

Organization

Ownership

Attention to detail

Tools

Excel

Word

Outlook

Google Sheets

Job description

About Alaffia & Our Mission

Every year, U.S. health plans lose billions to improper payments and administrative waste. That wasted spending ultimately trickles down across the healthcare ecosystem, driving up costs for plans, providers, and patients alike. We’re here to change that paradigm.

Alaffia is a new kind of claims operations partner for health plans. Using expert clinicians and transparent AI, we deliver deeper insights, smarter automation, and consistently better outcomes across the entire lifecycle of claims. With Alaffia, health plans can cut wasted spending more effectively than ever — and provide their members the most affordable care.

We’re a high-growth, venture-backed Series B healthtech startup based in NYC and are actively scaling our company. Join us in helping to build a healthcare system that works better for everyone.

*This position requires current authorization to work in the United States. Unfortunately, we are not in a position to sponsor work visas at this time.

About the Role & What You'll Be Doing

As a Payment Integrity Operations Associate, you’ll be at the center of our audit execution and provider communication processes.You will manage the end-to-end audit lifecycle — from document requests and follow-ups to final findings delivery — ensuring every step is timely, compliant, and professional.

This is a fast-paced, detail-driven role ideal for someone who loves operations, thrives in a structured environment, and takes pride in excellent communication and customer service. You’ll collaborate closely with clinical reviewers, audit managers, and product teams to ensure seamless provider experiences and efficient audit throughput.

Your Responsibilities

• Own the audit lifecycle: Track and manage cases from initial document request to final audit finding, ensuring deadlines are met and communication is timely.

• Send and follow up on documentation requests: Coordinate with providers to obtain required medical records, maintaining professionalism and persistence in all outreach. Additionally, accessing customer electronic systems to obtain records when needed.

• Manage the provider inbox: Monitor incoming provider communications, triage requests, and respond to inquiries within established turnaround times.

• Compose and send audit finding letters: Prepare and deliver audit determinations and outcome communications, ensuring clarity and accuracy in all correspondence.

• Optimize workflows: Identify process gaps and inefficiencies; update SOPs to drive greater consistency, accuracy, and throughput.

• Maintain organized documentation: Log all communications, updates, and task completions within internal systems to ensure full audit traceability.

• Collaborate cross-functionally: Work closely with clinical auditors, appeal teams, and product teams to resolve issues and ensure smooth handoffs.

• Deliver a high-touch provider experience: Represent Alaffia Health professionally in all interactions — balancing compliance with empathy and customer care.

Who You Are

• 4+ years of experience in healthcare operations, provider relations, or audit support (payment integrity, utilization review, claims, or revenue cycle experience preferred)

• Excellent written and verbal communication skills — able to write clear, professional correspondence to providers and clients.

• Highly organized and comfortable managing multiple concurrent workflows in a fast-paced environment.

• Strong sense of accountability and ownership; you take initiative and don’t let details slip.

• Exceptionally detail-oriented with a keen eye for accuracy and completeness in documentation, communication, and data entry.

• Familiarity with claims auditing, medical record procurement, or health plan operations is a plus.

• Proficient in Microsoft Office Suite (Excel, Word, Outlook) and Google Workspace (Docs, Sheets); comfortable using formulas, filters, and pivot tables for tracking and reporting.

Our Culture

Alaffia was born out of our founders’ personal connection to the inefficiency of the U.S. healthcare system. We are deeply mission-driven, with an abiding belief that technology can help create a better future for everyone —and we’re looking for others who share our passion for change to join the team.

What Else Do You Get?

• Competitive compensation package (cash + equity)

• Medical, Dental and Vision benefits

• Flexible, paid vacation policy

• Work in a flat organizational structure — direct access to Leadership