What are the responsibilities and job description for the Payment Integrity Analyst position at LifeBridge Health?
Summary
Who We Are:
LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to “improve the health of people in the communities we serve.” Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care.
LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to “improve the health of people in the communities we serve.” Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care.
CANDIDATES MUST RESIDE IN MD, DC, PA, VA OR WVA
About the Role:
Payment Integrity Analyst is responsible for monitoring, identifying and investigating discrepancies between the expected and actual reimbursement received from the payers on medical claims, analyzing the root causes of these variances. Takes corrective actions to maximize collections by ensuring accurate billing and coding practices. Ensures payer contracts, appeal guidelines and payer regulations are followed
KEY RESPONSIBILITIES:
- Analyzing payment data: Reviews payment variances to identify trends and patterns in underpayments or overpayments from payers.
- Payer contract review: Understands and interprets payer contracts and their reimbursement methodology utilized in healthcare payments to ensure accurate billing practices and identify potential reimbursement issues based on fee schedules, payer policies and coding guidelines.
- Root cause analysis: Investigates the reasons behind payment variances.
- Evaluate and identify insurance payment variances from zero payments, full denials, and line-item denials, and determine root cause of underpayments.
- Take necessary actions to recover insurance underpayments due to payer downcoding, incorrect coding, billing errors, system glitches, or payer policy changes.
- Appeals management: Initiates appeals for payment variances. Contacts payer, gather and compare pricing information via EOBs, contracts, payor policies, patient benefits to effectively initiate appeals.
- Collaborate with payer representatives and LifeBridge Health’s Managed Care department to resolve billing disputes and recoup underpayments
- .Reporting and communication: Generate comprehensive reports on payment variance trends, identify areas of improvement and communicate findings to leadership. Process improvement initiatives: Works closely with each department responsible for root causes to assist in preventing underpayments. Participates in projects to streamline billing processes, improve claim accuracy, and minimize payment variances
REQUIREMENTS:
- Education: HS Diploma/GED preferred
- Experience: 3-5 years of experience
- Licenses and Certifications: Certified Coding Specialist-Physician Based or Certified Professional Coder required within one year of employment.
- You may be asked to come onsite if productivity and quality measures are not met.
KEY WORDS
CPC
CCS-P
Additional Information
What We Offer:Impact: Join a team that values innovation and outcomes, delivering life-saving care to our youngest and most vulnerable patients.
Growth: Opportunities for professional development, including tuition reimbursement and developing foundational skills for neonatal critical care leadership and advanced certification.
Support: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support — improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license.
Benefits: Competitive compensation (additional compensation such as overtime, shift differentials, premium pay, and bonuses may apply depending on job), comprehensive health plans, free parking, and wellness programs.
Why LifeBridge Health?
With over 14,000 employees, 130 care locations, and two million annual patient encounters, we combine strategic growth, innovation, and deep community commitment to deliver exceptional care anchored by five leading centers in the Baltimore region: Sinai Hospital of Baltimore, Grace Medical Center, Northwest Hospital, Carroll Hospital, and Levindale Hebrew Geriatric Center and Hospital.
Our organization thrives on a culture of CARE BRAVELY—where compassion, courage, and urgency drive every decision, empowering teams to shape the future of healthcare.
LifeBridge Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression. LifeBridge Health does not exclude people or treat them differently because of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression.