Tech Stack

Description

You will execute internal audit frameworks to identify payment discrepancies, perform root-cause analysis on complex claims, and prepare documentation for external client audits. This role focuses on ensuring payment accuracy through data-driven quality assurance and collaborating with Operations and Product/Engineering teams to improve payment workflows.

Requirements

• 4+ years experience in healthcare claims, payment integrity, or financial auditing
• Strong understanding of payment cycles, claims adjudication, or billing integrity
• Experience with data and analytics tools (e.g., Looker)
• Uncompromising attention to detail and ability to manage multiple audit workstreams
• Ability to document findings and explain complex payment logic to diverse stakeholders

Responsibilities

• Conduct data-driven quality assurance audits on internal payment transactions for policy and regulatory adherence
• Support external client audits by gathering documentation and validating data accuracy
• Perform deep-dive root-cause analysis on payment discrepancies
• Track audit findings and create dashboards to highlight trends for Operations and Product/Engineering
• Identify friction points in payment workflows and propose system or procedural improvements