Job Overview
Location
Remote
Job Type
Full-time
Category
Operations
Date Posted
May 20, 2026
Full Job Description
đź“‹ Description
- • The Payment Cycle Analyst III is responsible for conducting systemic and targeted analysis to identify reimbursement errors and determine root causes, ensuring accurate claims processing and payment integrity for providers and members.
- • Day-to-day responsibilities include researching claim discrepancies, developing business requirements for payment decisions, leading special projects to resolve payment issues, validating test scripts and results, and communicating findings to stakeholders across Configuration, IT, UAT, Reimbursement Committee, and provider groups.
- • CareSource Management Group Company is a mission-driven healthcare organization dedicated to improving access to quality care, fostering innovation in payment systems, and supporting equitable health outcomes through rigorous reimbursement analysis and collaboration.
- • In this role, the analyst will deepen expertise in healthcare reimbursement methodologies, gain leadership experience in cross-functional project management, and develop advanced skills in claims analysis, testing validation, and regulatory compliance—positioning them for growth into senior reimbursement or payment integrity leadership roles.
🎯 Requirements
- • Bachelor’s degree required (or equivalent relevant work experience)
- • Five (5) years of health plan experience or equivalent experience with health plan operations and configuration
- • Experience with user testing and understanding of regression, unit, and user acceptance testing
- • Advanced proficiency in Microsoft Suite (Word, Excel, PowerPoint, Access, Visio)
- • Strong analytical skills with ability to communicate findings effectively to leadership and cross-functional teams
- • Understanding of healthcare field, including Medicaid, Medicare, Marketplace, and CMS guidelines/HIPAA/Affordable Care Act
🏖️ Benefits
- • Competitive salary range of $72,200.00 - $115,500.00
- • Potential for performance-based bonus tied to company and individual results
- • Comprehensive total rewards package supporting employee total well-being
- • Opportunity for up to 15% occasional travel to attend meetings, trainings, and conferences
- • General office environment with flexibility for remote work
- • Organization-level competencies fostering collaborative workplace culture, partnership development, and personal excellence
Skills & Technologies
About CareSource Management Group Company
CareSource is a nonprofit, multi-state managed care organization headquartered in Dayton, Ohio. Founded in 1989, it administers Medicaid, Medicare Advantage, and Marketplace health plans serving over two million members in Ohio, Kentucky, Indiana, West Virginia, and Georgia. The company focuses on improving health outcomes for low-income and vulnerable populations through integrated care management, behavioral health services, and social determinants programs.
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