Senior Payment Integrity Analyst at Redesign Health

| Greater NYC Area
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About Anomaly

Anomaly is a healthcare technology company with a bold mission: to bring precision payments to healthcare.

Healthcare billing is complex, prone to errors, waste, abuse, and fraud—at a cost of over $300 billion annually. Precision payments means the right amount is paid the first time, so the focus is on members, not on payment paperwork. Cutting-edge AI/ML technology immediately catches anomalous claims, enabling payments to flow with precision. Anomaly's team of technical, clinical, and operational experts is working with innovative payers and employers to implement this vision. Our team includes the former CEO of UnitedHealthcare Employer & Individual, head of engineering of Foursquare and Redesign Health, and formers from Optum, Apple, Google and other leading tech and healthcare companies.

Anomaly, currently in stealth mode, was incubated by Redesign Health.

About Redesign Health

Redesign Health is a healthcare innovation platform. The Redesign team brings together entrepreneurs, industry experts, and investors to fund and launch companies that transform the healthcare system and empower people to live their healthiest lives. Their first companies include Lively, Ever/Body, Vault Health, Springtide, HealthQuarters, Calibrate, and stealth ventures in payment integrity, sleep therapy, elder care, and complex care. Redesign is capitalized with permanent capital from world-class institutional investors and entrepreneurs.

About the Senior Payment Integrity Analyst Role

The Senior Payment Integrity Analyst will use an organized approach to perform the analysis, assessment and reporting activities related to the detection of fraud, waste, and abuse in medical and/or pharmacy claims. 

Responsibilities
  1. Conduct independent research through both internal & external sources and databases
  2. Conduct an assessment of incoming lead referrals, and complete related documentation
  3. Perform data analysis of claims history to substantiate fraud and abuse allegations
  4. Interact / coordinate activities with all levels of leadership and clients about course of investigation or analytical development
  5. Prepare accurate reports to detect and identify fraud trends, analysis of those trends and risk mitigation recommendations
  6. Present findings to clients
  7. Create and update automated processes within databases
  8. Use reporting tools to analyze large data sets  
  9. Assist leadership staff in developing and maintaining specific work procedures, policies and process improvement projects
Requirements
  • Undergraduate degree 
  • 5+ years of combined experience in healthcare, such as prior work in health insurance, claims processing or adjudication, or fraud detection
  • 2+ years of experience with provider claims data and facility or pharmacy coding
  • 2+ years of experience performing data analytics with large data sets using data visualization tools such as Tableau
  • Proficiency working with MS Excel including formulas, calculations, pivots
  • Ability to work independently and in a team environment to deliver results
  • Understanding of Project Management Methodology and best practices
  • 2+ years of previous experience interacting with business leadership
  • Ability to prioritize tasks, multi-task, and solve problems under tight deadlines
Nice-to-Have
  • Math, Qualitative, or Computer Science degree 
  • Proficiency with SAS or SQL
  • Knowledge of Managed Care, Medicare, or Medicaid
  • Experience in writing technical requirements for programmers
  • Experience in creating reports or visual data dashboards
  • AAPC

Apply here. Questions? Send us an email at [email protected].

Anomaly’s values

Anomaly’s mission is to bring precision payments to healthcare. To do so, we live by the following values: 

  • Move with urgency: Our customers needed our product yesterday. We move fast—but not too fast—to bring our solution to market
  • Be willing to sit on the floor: No one is too senior to jump in and get the job done
  • Think 10x: We celebrate incremental improvements, but we always look for the step-function win
  • Do the right thing, even when it's hard: We put privacy and security first, and treat all data with the care like it’s our own
  • Seek feedback at 30%: We ask for feedback uncomfortably early, and offer it proactively (and respectfully) to others
  • Default to open: We internally share everything we can, creating a culture of trust and empowerment
  • Be kind: We take our work seriously, but we’re never too busy to be kind

We want to hear from you regardless of your race, religion, national origin, sex, gender identity, sexual orientation, disability, age, veteran status, or any other applicable legally protected characteristics. We are a proud Equal Opportunity Employer – we recruit, train, compensate and promote our team members based on qualifications and performance. We know how important it is to not only include but actively seek out a diversity of opinions and voices.


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Technology we use

  • Engineering
    • JavaLanguages
    • JavascriptLanguages
    • PythonLanguages
    • SqlLanguages
    • HTMLLanguages
    • GraphQLLanguages
    • ReactLibraries
    • PostgreSQLDatabases

Location

Redesign Health, New York, NY 10003

An Insider's view of Redesign Health

What's something quirky about your company?

Every Friday in the office is "Floral Friday." It started out with everybody wearing Hawaiian shirts and has since been rebranded to include any and all festive items of clothing.

Jeanne

Senior Talent Analyst

What are Redesign Health Perks + Benefits

Redesign Health Benefits Overview

- Competitive pay
- Comprehensive health and wellness benefits and perks
- Lunch & Learn sessions hosted by internal and external industry experts featuring topics ranging from “Qualities of a Strong Consumer Brand” to “Combating Unconscious Bias”
Variety of functional, social, and community focused groups and meetups across the Redesign ecosystem and portfolio
- Fully stocked kitchen with plenty of coffee and tea, cold brew and iced tea on tap, a Bevi machine, and a variety of snacks
- Dog friendly office
- Annual learning stipend
- 16 week parental leave

Culture
Friends outside of work
Eat lunch together
Team owned deliverables
Group brainstorming sessions
Open office floor plan
Diversity
Dedicated Diversity/Inclusion Staff
Unconscious bias training
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Dental Benefits
Vision Benefits
Health Insurance Benefits
Onsite Gym
Child Care & Parental Leave Benefits
Generous Parental Leave
Flexible Work Schedule
Vacation & Time Off Benefits
Unlimited Vacation Policy
Perks & Discounts
Casual Dress
Commuter Benefits
Company Outings
Stocked Kitchen
Some Meals Provided
Happy Hours
Pet Friendly
Professional Development Benefits
Job Training & Conferences
Acme Co. offers employees professional development opportunities like Annual individual budget for training.
Lunch and learns
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