Payment Integrity Operations Analyst - Alaffia Health

About Alaffia & Our Mission

The U.S. healthcare system suffers from over $300B in improper payments each year due to fraud, waste, abuse, and processing errors. We’re on a mission to change that. To best prevent inaccurate payments, we’ve assembled a team of experienced technologists and industry-leading healthcare domain experts. The Alaffia team has alumni ranging from Amazon, Goldman Sachs, the Centers for Medicare and Medicaid Services, and other leading healthcare and financial institutions. We’re also backed by industry-leading venture capital firms!

If you want to make a major impact at the core of U.S. healthcare by implementing the latest in cutting-edge technologies, then we’d like to meet you.

Our Culture

At Alaffia, we fundamentally believe that the whole is more valuable than the sum of its individual parts. Further to that point, we believe a diverse team of individuals with various backgrounds, ideologies, and types of training generates the most value. Our people are entrepreneurial by nature, problem solvers, and are passionate about what they do — both inside and outside of the office.

About the Role & What You’ll Be Doing

Join our dynamic team at Alaffia as a Payment Integrity Operations Analyst, where you'll play a vital role in supporting various functions of our operations. In this role, you'll be instrumental in developing standard operating procedures (SOPs) across different aspects of our bill review solutions, ensuring operational excellence and efficiency. 

As a client-facing member of our team, you'll prepare and distribute reports, handle documentation requests, and provide timely updates and communication to our clients. You'll collaborate closely with internal stakeholders, including engineers and other team members, to drive improvements and inform decisions that shape the future of healthcare.

Your Responsibilities

• Develop and implement standard operating procedures (SOPs) across different functions of our bill review solutions
• Prepare and distribute reports to clients, ensuring accuracy and timely delivery
• Handle documentation requests to facilities, ensuring compliance with established protocols
• Communicate with clients to inform them of missing documents and request necessary information
• Maintain status updates on claims, keeping our internal web application up to date
• Collaborate with internal teams to address client needs and escalations promptly to drive continuous improvement
• Assist in the creation and maintenance of client-facing documentation, including training materials and user guides
• Conduct regular audits of operational processes and documentation to ensure compliance with industry standards and regulatory requirements
• Stay informed about industry trends and best practices in payment integrity and healthcare operations, and proactively identify opportunities for process improvement

What We’re Looking For

• Bachelor's degree in a related field 
• Prior experience in healthcare operations, payment integrity, or related fields preferred
• Strong attention to detail and ability to manage multiple tasks simultaneously
• Excellent communication skills, both written and verbal, with the ability to interact professionally with clients and internal stakeholders
• Proficiency in Microsoft Office Suite and other relevant software applications
• Ability to work independently and as part of a team in a fast-paced, dynamic environment
• Tech-savvy with a willingness to learn and adapt to new technologies and processes
• Strong organizational skills and ability to prioritize tasks effectively
• Experience with SOP development and documentation preferred

What Else Do You Get Working With Us?

• Medical, Dental, and Vision benefits
• Flexible, paid vacation policy
• Work in a flat organizational structure — direct access to Leadership