Payment Integrity Analyst III - Remote

Overview

The Payment Integrity Analyst III at Rialtic will research and interpret healthcare policies to promote payment accuracy and transparency.

In Short

• Review healthcare policy for coding and billing guidelines.
• Collaborate with teams to create billing edits for clients.
• Ensure structural design aligns with policy intent.
• Build unit tests to verify functionality of edits.
• Apply expertise in revenue cycle, coding, and billing.
• Conduct in-depth research on regulations.
• Validate edits are working as intended.
• Maintain current knowledge of claim edit references.
• Collaborate with Content and Engineering teams.
• Meet weekly productivity and quality goals.

Requirements

• Bachelor’s Degree preferred in Healthcare or Technology.
• 8+ years of professional experience in Healthcare.
• Experience working for a payer or editing vendor.
• Payment accuracy experience with prepayment or post-payment knowledge.
• Intermediate proficiency in Excel.
• Understanding of claims workflow and claim forms.
• Experience reading Medicare/Medicaid data and policy.
• Ability to communicate and collaborate with different departments.
• Proficient computer skills.

Benefits

• Freedom to work from anywhere with a home office stipend.
• Equity and 401(k) matching.
• Unlimited PTO and comprehensive health plans.
• Mental and physical wellness support.