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    Payment Integrity Analyst - New York, United States - RCM Health Care Services

    RCM Health Care Services
    RCM Health Care Services New York, United States

    1 week ago

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    Description

    Payment Integrity Analyst - Hybrid Role

    This company has been dedicated to fostering strong relationships with members and providers to promote healthy living in New York for over 30 years. They offer top-notch healthcare services throughout Bronx, Brooklyn, Manhattan, Queens, and Staten Island through a wide range of products.

    Position Overview

    • Develop strategic roadmap for recovering, eliminating, and preventing unnecessary medical-expense spending
    • Optimize claim accuracy programs to drive year-over-year value
    • Utilize analytics, trends, and competitor benchmarking to identify savings opportunities

    Job Summary

    • Build a stellar payment integrity unit to proactively identify and resolve payment issues
    • Create a roadmap to prevent unnecessary medical expenses
    • Identify overpayment/underpayment opportunities through data analysis
    • Support claim accuracy program and develop mitigation strategies
    • Manage financial recovery vendor relationships
    • Analyze performance trends and streamline processes
    • Develop payment integrity policies and procedures

    Minimum Qualifications

    • Bachelor's degree required
    • 5+ years of claims experience in healthcare or insurance industry
    • Extensive knowledge of provider payment methods, medical terminology, and data analysis
    • Experience with Excel and data systems

    Salary Range: $80,000 - $86,000.00 with pension plan benefits

    About the Company

    RCM Health Care Services is dedicated to connecting qualified candidates with medical opportunities. With a track record of trust and timely results since 1975, we provide staffing solutions to healthcare institutions nationwide. As career matchmakers, we guide clients and candidates towards their life and career aspirations. Our commitment to excellence is recognized through the Joint Commission Gold Seal of Approval.

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