The Payment Integrity Analyst I supports the accuracy, consistency, and timely resolution of payment-related activity. The role's primary assignment is monitoring High Return Rate reporting and managing related cases through research, documentation, direct client communication, remediation follow-up, appropriate escalation, and closure. The analyst uses approved return-rate reporting and the designated case-management tracker to convert flagged activity into timely, documented action. The analyst applies established procedures and sound judgment to recognize trends, discrepancies, recurring issues, and potential risks, taking timely action within the role's authority and escalating matters that require management review.
Cross-training across additional Payment Integrity processes is a secondary responsibility that supports operational coverage and continuity after proficiency in the primary assignment is established.
Essential Responsibilities
Skills and Competencies
Experience
Work Schedule
This position must work a schedule aligned with U.S. business hours, including availability during the core hours established by management to support client communication, case follow-up, and team coordination.
Role Scope
This is a professional individual-contributor role. The analyst independently executes approved monitoring and case-management procedures, applies judgment to routine and moderately complex situations, and escalates decisions involving elevated risk, policy interpretation, account restrictions, funding suspension, technical direction, or broader process ownership.
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