Drive initiatives that identify and deploy cost-saving opportunities within healthcare claims, leveraging SQL expertise to improve claims payment accuracy and drive operational improvements.
The Payment Integrity team is a group of innovative thinkers sitting at the intersection of Clover's provider network, claims, and technology teams. The Payment Integrity team ensures that Clover pays claims in an accurate manner, with a particular focus on reducing inappropriate medical spending.
As a Payment Integrity Analyst, you will be responsible for identifying, researching, developing, and maintaining a portfolio of medical cost savings opportunities. This position will leverage strong technical knowledge to build complex SQL queries to size and ultimately deploy high-value individual cost-savings concepts as well as assist with the identification of these audit opportunities. In addition, the Senior Associate will be responsible for the creation of monthly, quarterly, and annual Payment Integrity financial reports as well as ad-hoc reports to support operations.
As a Payment Integrity Analyst, you will:
Success in this role looks like:
You should get in touch if:
Benefits Overview:
Additional Perks:
About Clover: We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. We believe the healthcare system is broken, so we've created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most.
We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
From Clover’s inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences, perspectives, opinions, and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one’s identity. All of our employee’s points of view are key to our success, and inclusion is everyone's responsibility.
#LI-REMOTE
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company.
Final pay is based on several factors including but not limited to internal equity, market data, and the applicant’s education, work experience, certifications, etc.
Equity Compensation
Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
Flexible Work Hours
Remote-first culture, enabling collaboration with global teams
Home Office Stipend
Reimbursement for office setup expenses
Paid Parental Leave
Paid parental leave for all new parents
Paid Time Off
a generous flexible time-off policy
Clover Health builds innovative health insurance solutions that leverage data and technology to improve patient outcomes. We focus on empowering clinical staff with custom software and analytics to deliver personalized care, particularly for those managing chronic conditions. Our approach combines advanced AI capabilities with a deep understanding of human empathy to transform the healthcare experience.
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