Payment Integrity Analyst- COB

📋 Description

• • The Payment Integrity Analyst (COB) supports the Coordination of Benefits (COB) program by investigating and validating other insurance coverage, resolving conflicting eligibility information, and establishing the correct order of liability (primary vs. secondary payer) to prevent and recover improper claim payments.
• • Day-to-day responsibilities include reviewing and prioritizing COB leads, investigating coverage details using internal systems and payer portals, contacting third parties for verification, creating detailed case notes, updating eligibility records, and applying COB rules to determine correct payer order.
• • The role operates within Lyric, an AI-first healthcare technology company and market leader in pre-pay editing with 35 years of expertise, recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity, and committed to reducing waste in healthcare through accurate payment integrity.
• • The analyst will develop expertise in healthcare claims processing, COB regulations (CMS/NAIC), data analysis using Excel and SQL, and process improvement, while contributing to accurate payment outcomes and gaining experience in a high-volume, SLA-driven environment focused on healthcare innovation.