Payment Integrity Analyst II - Data Mining

📋 Description

• • The Payment Integrity Analyst II (Data Mining) role at Lyric supports the Data Mining program by investigating moderate-to-complex payment errors from incorrect processing of payment policies, contract terms, billing, and coding to prevent and recover improper claim payments.
• • Day-to-day responsibilities include reviewing and prioritizing DM leads, investigating payment terms using internal systems and contracts, applying payment policies and coding guidelines (CPT, ICD-10, HCPCS, DRG, etc.), reconciling discrepancies, documenting audit-ready determinations, collaborating on client-specific business rules, maintaining validation libraries, preparing documentation for disputes, and contributing to process improvements through trend analysis and tool enhancements.
• • Lyric is an AI-first healthcare technology company with 35 years of pre-pay editing expertise, recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity, HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience, committed to reducing healthcare waste and improving payment accuracy for payers, providers, and patients.
• • The role offers opportunities to develop advanced analytical and investigative skills in healthcare payment integrity, gain expertise in medical billing codes and reimbursement methodologies, contribute to process improvements with measurable impact, work autonomously on complex cases, and support scalable payment integrity outcomes through cross-functional collaboration and innovation in a mission-driven environment.