Payment Integrity Business Analyst

Job Description

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members.

The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics.

Sagility has more than 25,000 employees across 5 countries.

Job title:

Payment Integrity Business Analyst

Job Description:

Sagility is a tech-enabled BPM services provider, a thought partner providing a broad spectrum of transformational services, to enable our clients provide efficient and hi-quality care across the healthcare system.

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members.

We optimize the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics.

Leading industry analyst firms have consistently cited our service excellence, breadth of offerings, and ability to execute.

The most recent being recognized as a leader for Healthcare Payer Operations in 2022 as a part The Healthcare Payer Operations PEAK Matrixｮ Assessment report by Everest Group.

We have 38,000+ employees in 15 cities across 5 countries ? India, Philippines, USA, Jamaica, and Colombia.

About SPIS (Sagility Payment Integrity Services)

Sagility? s approach to Payment Integrity (PI) is a collaboration between our Data Mining, Coding and Clinical teams that provides predictable operational excellence through analytics-led, technology-driven solutions.

Backed by our proprietary Intelligent Content Processing (ICP) software, we deliver high quality, broad automation driven for more accurate audit findings.

Through our HITRUST certified platform, Contract Central, we provide Data Mining, Clinical and Claims Repricing solutions that enhance claims payment accuracy and ensure significant savings in both pre and post-pay.

Our team is currently seeking a talented Payment Integrity Business Analyst who will focus on Audit and help the user identify overpayment opportunities or to support analysis and review of activity for reporting and process improvement purposes.

This role is a strong partner with the Audit team to resolve claims issues, pricing, and fix contract issues, as needed the candidate will interact with the IT team to obtain assistance where needed.

Job Summary:

The Payment Integrity Business Analyst will play a pivotal role in analyzing and improving payment processes within a healthcare organization.

This role requires an individual who is highly analytical and is comfortable working in a less defined work environment with cross-functional teams to optimize payment workflows, detect errors, and ensure compl...