Sr Payment Integrity Consultant - Payment Integrity

Luminare Health Benefits Inc.; Chicago (IL); Hybrid; USD 70,000 - 126,000; Full time

Job summary

HCSC is seeking a Business Requirements Analyst to drive the implementation of PI-owned projects and report on status and risks. You will work with cross-functional teams to identify payment integrity opportunities and track KPIs, drafting communications on progress, impact and ROI.

The role requires a Bachelor's degree with related health insurance experience and strong MS Office skills. This hybrid role includes three days in the office and two days remote.

Qualifications

• Bachelor's degree or higher with 3+ years of business requirements experience in health insurance.
• Knowledge of payer operations and health insurance processes.
• Experience in implementation projects.
• Strong written and verbal communication skills.
• Proficiency in Microsoft Access, Excel, Word and PowerPoint.

Responsibilities

• Drive implementation of PI-owned projects and report status and risks.
• Identify new payment integrity opportunities while coordinating with cross-functional teams.
• Track KPIs and impact metrics and draft communications on project progress, impact and ROI.
• Collaborate with PI Program Manager to ensure alignment with program goals.

Skills

Payer operations knowledge

Implementation experience

Interpersonal communication

Microsoft Office proficiency

Education

Bachelor's degree

Tools

Microsoft Excel

Microsoft Access

Microsoft Word

PowerPoint

Job description

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.

Job Summary

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.

Required Job Qualifications

• Bachelor's degree and 3 years of business requirement experience OR 7 years of business requirements experience in health insurance operational functionsor 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

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

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

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.