Business Project Lead Analyst – Payment Integrity

Job Description: • Lead strategic collaboration between recovery vendors, providers, and internal network partners • Drive monthly provider and vendor discussions to review overpayment inventory • Partner with Network and Contracting teams to address uncooperative providers • Monitor vendor performance and accuracy, translating findings into corrective action plans • Serve as a subject matter expert on claim identification and recovery processes • Support client-driven and third-party audit initiatives by reviewing, analyzing, and reporting on recovery accuracy • Evaluate provider contract audit language and recommend enhancements • Analyze trends, exclusions, and provider behaviors to quantify financial impact • Develop and deliver clear, actionable reporting for leadership, providers, vendors, and external stakeholders • Enable vendor success through education on systems, procedures, and evolving recovery requirements Requirements: • High School Diploma or G.E.D. required • 3+ years of experience in payment integrity, provider relations, claims operations, or related healthcare analytics roles • 2+ years of hands-on experience with healthcare claim systems such as PROCLAIM and FACETS • Working knowledge of healthcare claim processing and recovery workflows • Experience partnering across matrixed teams including Network, Legal, Contracting, Sales, and Operations • Strong analytical and organizational skills • Demonstrated ability to manage complex issues with appropriate urgency and sound judgment • Proficiency in Microsoft Word and Excel Benefits: • Medical, vision, and dental health insurance • 401(k) • Company paid life insurance • Tuition reimbursement • Minimum of 18 days of paid time off per year • Paid holidays Apply tot his job Apply To this Job