InnovAge · 3 hours ago
Payment Integrity Analyst
United States
Full-time
Remote
Mid Level
$77K/yr - $97K/yr
4+ years expInnovAge is dedicated to empowering seniors to live independently, allowing them to age in their own homes and communities safely. The Payment Integrity Analyst provides quality and operational support for PACE program administration, including claims auditing support, testing, data analysis, issue resolution, systems support, and process improvement initiatives.
Health CareHome Health CarePersonal Health
Responsibilities
Analyze, troubleshoot, and resolve operational issues related to claims, provider networks, and benefits
Act as a liaison between internal departments (e.g., IT, claims, customer service) and external vendors or PACE program partners
Monitor claims quality and integrity in systems and work with IT or other teams to resolve discrepancies
Maintain documentation of workflows, business rules, and process changes
Support the implementation of newly covered services and upgrades through coordination with cross-functional teams
Create and distribute reports, provide analyses to support business decisions and ensure compliance with regulatory requirements
Assist with testing system updates and enhancements, including user acceptance testing (UAT)
Identify process improvement opportunities and participate in initiatives to enhance operational efficiency and member experience
Stay updated on regulatory and industry changes affecting PACE program operations
Qualification
Required
Bachelor's degree in healthcare administration, business, or related field, or equivalent work experience
4+ years of experience in claims healthcare environment or health insurance
Strong analytical and problem-solving skills
Proficient in Microsoft Excel, with experience using data tools and reporting software
Excellent written and verbal communication skills
Ability to work independently and collaboratively in a fast-paced environment
Preferred
Experience with payer health plan systems (e.g., Plexis, Facets, QNXT, Epic Tapestry, or similar)
Knowledge of HIPAA, Medicare, Medicaid, or ACA regulations
SQL or other data query skills a plus
Benefits
Medical/dental/vision insurance
Short and long-term disability
Life insurance and AD&D
Supplemental life insurance
Flexible spending accounts
401(k) savings
Paid time off
Company-paid holidays
Company
InnovAge
InnovAge mission is to enable seniors to age independently in their own homes for as long as possible.
1001-5000 employees
Funding
Current Stage
Public CompanyTotal Funding
unknown2021-03-03IPO
2016-05-16Acquired
Leadership Team
Patrick Blair
President & CEO
Benjamin C. Adams
Chief Financial Officer
Recent News
2025-12-30
2025-12-12
InnovAge Holding Corp.
2025-11-12
Company data provided by crunchbase