Sr Payment Integrity Consultant

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

• This is a hybrid opportunity that will work from the office 3 days a week. Must live in a commutable distance to the listed office.*

This position is responsible for driving delivery, contingency planning, business results, and strategic planning for highly complex program(s) consisting of multiple projects or initiatives in support of assigned line of business strategy. Oversees the day-to-day activities of project delivery and contingency execution strategy, vendors relationship management, and business partner engagement while managing various enterprise-wide projects or initiatives. Ensures integration between partner teams and serves as a functional business liaison in the development and implementation of program scope, timing, and budgets as needed, based on the needs of the business. Responsible for tracking key program milestones and recommending adjustments to program leadership and team.

Job Requirements:

• Bachelor degree and 3 years of business requirement experience OR 7 years of business requirements experience in health insurance operational functions or relevant experience

• Knowledge of and experience in payer operations

• Implementation experience

• Clear and concise interpersonal, verbal and written communication skills

• PC proficiency with Microsoft applications including access, excel, word and power point

Preferred Job Experience (HIGHLY PREFERRED):

• 1-2 years project management experience and ability to lead multiple projects - HIGHLY PREFERRED

• Knowledge of claims systems (Claims, BlueChip, ITS)

• Understanding of proper "Coding Guidelines" (ICD-10, etc.)

• Sponsorship will not be provided for this role.*

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.