Payment Integrity Analyst II

Title: Payment Integrity Analyst II

Location: Bellaire, TX, United States

The Payment Integrity Analyst contributes to overall cost reduction, by increasing the accuracy of provider payments in our claims system, and by ensuring correct claims payment. The analyst will partner with leaders and stakeholders to drive operational initiatives tied to payment integrity and provider claims accuracy. This position will help analyze data to identify trends and help drive decision making based on business needs and goals.

This role supports the execution of TCHP’s corporate wide claim payment accuracy strategy through supporting implementations of new initiatives and serving as a payment integrity liaison across multiple internal departments and external vendors in the development and maintenance of claim payment policy edits based on clinical, financial, and operations perspectives. The analyst will additionally collaborate with payment accuracy software vendors on the implementation and maintenance of industry standard payment policy coding edits, identification o