Associate, Payment Integrity (Data Mining)

📋 Description

• Provide SME for data mining workflows and program rules.
• Identify payment integrity issues and remediation steps.
• Identify post-payment errors and help recover payments.
• Represent data mining and payment integrity solutions in policy discussions.
• Provide training to team members as needed.
• Serve as SME using internal/external tools to audit and guide.

🎯 Requirements

• 3+ years of experience in claims processing, auditing or health care operations.
• 3+ years building or supporting data mining payment integrity solutions.
• Proven ability to work independently to drive projects to completion.
• Some coding experience or database language exposure.
• Bachelor’s degree (bonus).
• Experience using SQL.

🎁 Benefits

• Medical, dental, and vision benefits.
• 11 paid holidays, paid sick time, paid parental leave.
• 401(k) plan participation, life and disability insurance.
• Paid wellness time and reimbursements.
• Annual performance bonuses.
• Unlimited vacation program.