Payment Integrity Analyst - COB

Payment Integrity Analyst (COB)

Required skills and experience: 1-3+ years of healthcare claims, benefits, COB, or payment integrity experience Understanding of payer operations and insurance coverage rules Experience analyzing healthcare claims data Strong attention to detail and problem-solving skills Proficiency in Microsoft Excel and Microsoft Office Strong written and verbal communication skills Ability to manage multiple priorities in a fast-paced environment

Job description: We are seeking a detail-oriented Payment Integrity Analyst (COB) to support Coordination of Benefits (COB) investigations and payment accuracy initiatives. This individual will review healthcare claims, verify member eligibility and coverage, determine payer responsibility, and identify opportunities to prevent or recover inaccurate claim payments. Key responsibilities:

• Investigate and resolve Coordination of Benefits (COB) issues
• Review healthcare claims and member eligibility information
• Determine primary and secondary payer responsibility
• Research discrepancies and document findings
• Maintain accurate case records and audit documentation
• Collaborate with internal teams and external stakeholders
• Support payment accuracy and recovery initiatives