Sr Payment Integrity Consultant - Payment Integrity

Health Care Service; Chicago (IL); Hybrid; USD 70,000 - 126,000; Full time

Job summary

Health Care Service Corporation (HCSC) is seeking a results-driven professional to drive implementation of PI-owned projects, monitor status and risks, and identify new payment integrity opportunities with cross-functional teams.

This flexible hybrid role requires strong analytical abilities, KPI tracking, and clear communications on project progress, value, and ROI. The base pay range is $69,800–$125,900 with potential annual incentives.

Qualifications

• Bachelor's degree and 3 years of business requirements experience OR 7 years of business requirements experience in health insurance operational functions or relevant experience
• Knowledge of and experience in payer operations
• Implementation experience
• Clear and concise interpersonal, verbal and written communication skills
• PC proficiency with Microsoft applications including Access, Excel, Word and PowerPoint

Responsibilities

• Drive implementation of PI-owned projects and report status and risks
• Identify new payment integrity opportunities with cross-functional teams
• Track KPIs and impact metrics and draft communications on PI project progress, impact, value and ROI
• Collaborate with PI Program Manager on communications and progress updates

Skills

Interpersonal skills

Verbal communication

Written communication

Payer operations knowledge

Implementation experience

Education

Bachelor's degree in health insurance operations or related field

Tools

Microsoft Access

Microsoft Excel

Microsoft Word

PowerPoint

Job description

Job Summary

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

This position is responsible for driving implementation of PI-owned projects, reporting status and risks. While working with cross-functional teams, responsible for identifying new payment integrity opportunities. Responsible for tracking and reporting KPIs and impact metrics, working with the PI Program Manager to draft communications on PI project progress, impact, value, and ROI.

This is a Flex (Hybrid) role: 3 days in office; 2 days remote.

Required Job Qualifications

• Bachelor's degree and 3 years of business requirement experience OR 7 years of business requirements experience in health insurance operational functions or relevant experience
• Knowledge of and experience in payer operations
• Implementation experience
• Clear and concise interpersonal, verbal and written communication skills
• PC proficiency with Microsoft applications including access, excel, word and power point

Preferred Job Qualifications

• Healthcare background
• Project Management experience
• Experience managing vendor contracts
• Advanced excel experience

Pay Transparency Statement

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards .

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Flex employees are expected to be in the office a minimum of three days a week. Management will have discretion to modify an employee's weekly schedule for exigent circumstances.

HCSC Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Base Pay Range

$69,800.00 - $125,900.00

Exact compensation may vary based on skills, experience, and location.