Payment Integrity Analyst I-HP Benefit Configuration Christus Health United States, Texas, Irving Sep 22, 2026

Description Summary:

Under the supervision of the Configuration Manager, the Payment Integrity Analyst I will work in conjunction with Business Configuration, Claims, Network, Provider Data, Utilization Management, as well as other operational departments to ensure validation and quality assurance of benefit, contract, reimbursement, and overall financial analysis that arise during the overpayment identification and recovery process.

Responsibilities:

Identify, analyze, and interpret trends or patterns in complex data sets.

Leverages available resources and systems (both internal and external) to analyze claim information and take appropriate action for payment resolution; documents all activity in accordance with organization policies.

Performs review of claim projects resulting from overpayments or underpayments related to benefits, contracts, and fee schedule defects.

Performs root cause analysis and financial impacts of identified defective claims.

Communicates findings, including trends and recommendations to appropriate leadership.

Research, maintain, test, and create fee schedule tables from data obtained from CMS, Tricare (CHAMPUS), or custom rates into the claims system.

Research, maintain, and create provider reimbursement contract configuration.

Collaborate with and maintain open communication with all departments within

CHRISTUS

Health to ensure effective and efficient workflow and facilitate completion of tasks/goals.

Follow the

CHRISTUS

Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).

All other duties assigned by management.

Requirements:

Education/Skills High school diploma or equivalent experience in healthcare claims adjudication, system configuration, and auditing

Strong understanding of healthcare claims data, pricing, and claims editing concepts, including UB04 and

HCFA 1500

claim content

Strong working knowledge of health insurance concepts, practices, and procedures, including the understanding of provider payment methodologies and claims processing workflows, from receipt through final adjudication

Strong analytical and research abilities to triage issues and perform reconciliations or data analysis

Working knowledge of Federal and State regulatory rules regarding claims adjudication

Ability to organize and prioritize work to meet deadlines

Strong Microsoft Office application skills, including Microsoft Word and Excel (VLOOKUP, Pivot Tables, Index/Match, Formulas, and creating spreadsheets)

Strong organizational skills and the ability to manage multiple competing projects and deadlines

Ability to think creatively

Excellent written and verbal communication skills

Good judgment, initiative, and problem-solving abilities

Ability to handle and resolve complex issues independently

Knowledge of Commercial, Medicare Advantage, Tricare, and Health Care Exchange programs preferred

Knowledge of

CPT/HCPCS, ICD-10

coding, and medical terminology.

Ability to learn new policies and processes based on written material and observation

Ability to establish and maintain professional, positive, and effective work relationships

Demonstrated ability to collaborate effectively and work as part of a team in a fast-changing environment Experience 0-1 year of experience interpreting complex provider agreements, claims adjudication, system configuration, and auditing.

Work Schedule:

MULTIPLE SHIFTS AVAILABLE

Work Type:

Full Time