Payment Integrity Policy Analyst

JOB REQUIREMENTS: Payment Integrity Policy Analyst Job LocationsUS-WI-Madison ID 2025-2317 Category Claims Type Regular Full-TimeOverview Quartz is excited to launch a brand-new Payment IntegrityDepartment, and we're looking for an experienced Medical Coder to helpshape this critical function from the ground up. If you're passionateabout coding accuracy, payment integrity, and making a meaningful impacton healthcare affordability and quality, this is your opportunity tomake a difference for our members and providers. This role offers aunique chance to influence strategy, develop new policies, andcollaborate with a team that truly values both coding expertise andpayment integrity excellence. Benefits: Be a founding member of a newlycreated Payment Integrity department Play a key role in building andimplementing new policies and processes Collaborate with a team thatrespects and values your coding and payment integrity expertise Accessprofessional development opportunities to support your long-term growthStarting pay range based upon skills and experience: $71,000 to$88,800 + robust benefits package Responsibilities Investigate,analyze, develop and implement Payment Integrity Policies ResearchNational, Regional, and Local health plans Payment Integrity practicesto identify industry trends Analyze financial performance of Quartz,provider sponsors, and risk pools Reviews, analyzes, and responds tointernal or external audits related to Payment Integrity PoliciesMonitor regulatory compliance related to federal, state and ERISAregulations Develop provider appeal responses in collaboration withProvider Network Management Create educational materials to supportprovider understanding of Payment Integrity Policies Review and respondto escalated provider appeals Drive process improvements related toprovider abrasion and payment integrity workflows QualificationsBachelor's degree with 2 years of Payment Integrity, Coding Integrity,or Revenue Integrity Experience Or Associate's degree with 5 years ofExperience Or High School equivalency with 8 years of ExperienceCompletion of a Medical Coding Program Certifications in CPC, COC, RHIT,RHIA, CCA, and/or CCS Intermediate to Advanced knowledge in BusinessObjects and Excel Strong Understanding of: CMS and Commercial PayerPolicies Claims Processing and Reimbursement ICD-10 Coding & DRGValidation Healthcare Revenue Cycle Operations Confidence engaging withproviders, including discussions at the executive level Hardware andequipment will be provided by the company, but candidates must haveaccess to high-speed, non-satellite Internet to successfully work fromhome. We offer an excellent benefit and compensation... For full infofollow application link. Equal Opportunity Employer of Minorities,Females, Protected Veterans, and Individual with Disabilities APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/F305AB6C4F8140EA

Created: 2025-12-29