Operations Specialist, Payment Integrity
Clover Health(14 days ago)
About this role
An Operations Specialist on Clover Health's Payment Integrity team supports cost-containment efforts across Medicare Advantage and Direct Contracting by ensuring claims are paid accurately and overpayments are recovered. The role sits at the intersection of the provider network, claims, and technology organizations to support Clover’s mission of reinventing health insurance through data-driven approaches. This is a remote-first position within a company focused on improving member health and reducing inappropriate medical spend.
Required Skills
- Claims Review
- Provider Relations
- Process Improvement
- Project Management
- Excel
- Reporting
- Collaboration
- Communication
- Documentation
- Regulatory Compliance
+1 more
About Clover Health
cloverhealth.comClover Health is a Medicare Advantage provider offering HMO and PPO plans—many with $0 monthly premiums—bundling expanded benefits like dental, vision, and hearing. Headquartered in Jersey City, NJ, the company serves Medicare beneficiaries across multiple U.S. markets. Clover emphasizes a technology- and data-driven approach to care management, aiming to support providers, coordinate primary care, and improve member outcomes. It positions itself as a member-focused alternative designed to lower costs and simplify access to preventive and routine services.
Apply instantly with AI
Let ApplyBlast auto-apply to jobs like this for you. Save hours on applications and land your dream job faster.
More jobs at Clover Health
Provider Incentives Program Manager
Clover Health(4 days ago)
Manager, Actuarial Reserving and Financial Reporting
Clover Health(5 days ago)
Medical Director, Payment Integrity & Utilization Management
Clover Health(6 days ago)
Medical Director, Utilization Management (Part Time - Weekends)
Clover Health(6 days ago)
Similar Jobs
Associate, Payment Integrity
Oscar Health(21 days ago)
Payment Integrity Analyst
Collective Health(1 month ago)
Associate, Payment Integrity, IBR
Oscar Health(1 month ago)
Payment Integrity Associate - Itemized Bill Review
Oscar Health(29 days ago)
Associate, Payment Integrity, IBR
Oscar Health(1 month ago)
Payment Integrity Associate - Itemized Bill Review
Oscar Health(18 days ago)