Payment Integrity Business Solutions Lead (Complex Claims)

Tech Stack

Responsibilities

• Serve as the primary operational subject matter expert for payment integrity methodologies, audit programs, and product requirements.
• Translate payer pain points, contract language, audit policy, and operational workflows into product capabilities.
• Define audit concepts, savings opportunities, validation criteria, and defensibility standards across priority PI domains.
• Partner with engineering to define, develop, and build high-performing, scalable, trustworthy, reliable, and accurate AI solutions.
• Support roadmap prioritization, pilot launches, outcome reviews, positioning, and customer expansion.

Benefits

• Equity
• Health Insurance
• Remote Stipend

Culture

Requirements