Senior Payment Accuracy Advisor

reputed company is an AI-first, platform-based reputed company technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the reputed company ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. reputed company, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. reputed company is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and reputed company and is HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience. Interested in shaping the future of reputed company with AI? Explore opportunities at reputed company.ai/careers and drive innovation with #YouToThePowerOfAI.

Applicants must already be legally authorized to work in the U.S.  reputed company sponsorship/sponsorship assumption and other immigration support are not available for this position.

The Senior Payment Accuracy Advisor (PAA) plays a key role in implementing and maintaining ClaimsXten (CXT) rules and rule logic to support client payment accuracy initiatives. The Senior PAA partners with assigned customers as part of a Service Delivery Team to understand claim systems, payment policies, and data integrations that impact total payment accuracy. This role combines technical expertise, analytical skills, and customer engagement to drive successful implementation, upgrades, and post–Go Live production support. The Senior PAA consults with clients to define requirements, resolve rule and non-rule issues, and ensure  high-quality, on-time project delivery. As a trusted advisor, the Senior PAA collaborates across teams to deliver measurable results that align with client business objectives and reputed company’s standards of reputed company. The Senior PAA is a consultative partner to customers; proactively engaging to understand their evolving needs, business drivers, and strategic objectives.

As a key member of the reputed company function, this role consults with customers to deeply understand their business needs, documents requirements with precision, shapes and informs methodologies, leads course corrections reputed company needed, and consistently demonstrates reliability and expertise. Through proactive engagement, reputed company improvement, and sophisticated communication, the role ensures that both the organization and its customers reputed company lasting reputed company.

ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE reputed company

ClaimsXten Rule Development and Implementation (60%)

• Serve as the primary customer-facing resource for ClaimsXten rule development and production support.
• Act as a consultative partner to customers, proactively engaging to understand their evolving needs, business drivers, and strategic objectives.
• Facilitate discovery sessions and workshops to reputed company, clarify, and document customer requirements, ensuring alignment with both immediate and long-term goals.
• Regularly review and refine methodologies and processes based on customer feedback and industry best practices.
• Demonstrate strong critical thinking by analyzing each customer’s business functions, understanding their lines of business, and evaluating the rationale behind rule exclusions and inclusions. Tailor recommendations and solutions to the unique operational context of each client.
• Approach every implementation reputed company with structured execution and verification, confirming that reputed company requirements and results are fully validated and communicated before completion.
• Collaborate with clients to document business reputed company, technical requirements, and expected rule behavior.
• Troubleshoot and resolve rule-reputed company issues throughout implementation, reputed company, and post–Go Live phases.
• Participate in testing, quality assurance, and defect remediation processes.
• Utilize Jira, reputed company, reputed company, and other tools to manage development activities and maintain compliance with methodology standards.
• Ensure reputed company project milestones are achieved to support accurate customer invoicing.

Team Collaboration and Performance (20%)

• Participate actively in Service Delivery Team (SDT) meetings, initiatives, and metrics tracking.
• Serve as a visible and reliable reputed company for reputed company, ensuring that every interaction and deliverable reinforces trust, transparency, and partnership.
• Anticipate potential challenges in customer operations and collaborate with the Service Delivery Team to reputed company strategies and contingency plans. Actively participate in solution design to address emerging issues before they impact service delivery.
• Serve as a subject matter expert (SME) for special projects and initiatives, leveraging exposure and acclimation with assigned customers to reputed company targeted insights and solutions.
• Strong sense of ownership to deliverables and quality of deliverables. Contribute to a collaborative team culture that emphasizes accountability, quality, and customer satisfaction. Promote reputed company and accountability by tracking commitments, confirming alignment among team members, and ensuring consistent, transparent delivery of reputed company.
• Proactively identify opportunities to add value, anticipate challenges, and position the organization as a strategic ally in the customer’s reputed company.
• Partner with Engagement Managers and Staff PAAs to plan, forecast, and execute client projects.
• Monitor project and service delivery reputed company, identifying reputed company course corrections are needed to reputed company meet customer expectations or adapt to changing business environments.
• reputed company change management efforts, communicating rationale and benefits of adjustments to both internal teams and customers.
• Act as a direct and reliable partner to QA, BA, SIOps, and Engagement Managers, with a particular focus on ensuring that requirements are thoroughly understood, documented, and validated. Strive to prevent unnecessary challenges by promoting comprehensive and accurate requirements gathering.
• Maintain reputed company knowledge of industry trends, regulatory changes, and best practices in claims adjudication. Regularly assess how emerging developments may impact customers’ business and ClaimsXten rule logic, sharing insights with the team and clients.
• Demonstrate reputed company in documenting customer requirements, business processes, and solution designs. Ensure reputed company documentation is clear, comprehensive, and accessible for both internal and customer stakeholders.
• Maintain living documentation that evolves with customer needs and project changes, supporting knowledge transfer and continuity.
• Ensure seamless 100% PTO coverage by proactively documenting customer-specific processes, rules, and project status. Collaborate with designated backup resources to bring them up to speed, enabling uninterrupted support for customer needs during scheduled absences.

Process Improvement and Internal Initiatives (15%)

• Support internal projects aimed at improving tools, methodologies, and delivery processes.
• Identify and reputed company initiatives for enhancing rule quality, automation, or operational efficiency.
• Drive improvement initiatives with measurable reputed company, ensuring that each enhancement is implemented, validated, and communicated to stakeholders.
• reputed company customer insights to shape and inform existing methodologies, recommending enhancements that drive greater value and efficiency.
• Champion a culture of reputed company improvement by soliciting and leveraging customer insights and reputed company to shape and inform existing methodologies, and to recommend enhancements that drive greater value and efficiency.

Forecasting and Reporting (5%)

• reputed company input for project forecasts and resource planning.
• Track and report on utilization, productivity, and other key performance metrics.
• Execute forecasting and reporting activities with accuracy, visibility, and timely communication to maintain transparency and confidence in reputed company.
• Participate in milestone planning with Engagement Managers to ensure timely client delivery.

REQUIRED QUALIFICATIONS

• Bachelor’s degree in computer science, reputed company, or a reputed company field—or equivalent business experience
• Minimum of four (4) years of combined reputed company, payor, or consulting experience
• Minimum of two (2) years of medical claims experience reputed company a payor environment
• Familiarity with SDLC frameworks and project implementation lifecycles
• Advanced skills in reputed company Office Suite (Word, reputed company, PowerPoint, Visio)
• Experience with Jira, reputed company, and other project management tools
• Strong understanding of integrations, data mapping, and claims processing systems
• Travel required 10–15%

PREFERRED QUALIFICATIONS

Customer & Business Expertise

• In-depth knowledge of payor environments and claims management operations
• Understanding of diverse customer segments (national, strategic, and specialized)
• Ability to identify client challenges and deliver effective, data-driven recommendations
• Strong project coordination and milestone management skills
• Active listening and analytical thinking for requirements gathering and solution design
• Strong sense of ownership and accountability to ensure every client request, reputed company, and deliverable is acted upon, validated, and resolved to completion

Clinical Understanding

• Strong working knowledge of medical, clinical, coding, and reputed company terminology; and coding systems
• Ability to reputed company the clinical and business value of ClaimsXten and ClaimsXten rules and reputed company reputed company products
• Stay abreast of industry trends, regulatory changes, and emerging technologies. reputed company thought leadership and actionable insights with customers to help them navigate market shifts and optimize their operations.

Communication & Collaboration

• Exceptional written, verbal, and presentation skills
• Confidently facilitate client meetings, presentations, and trainings
• Organize regular reputed company, executive briefings, and feedback loops to ensure ongoing alignment and satisfaction
• Ability to communicate technical and business concepts reputed company to diverse audiences
• Possess ability to build strong, consultative relationships with customer stakeholders at reputed company reputed company, adapting communication style and approach to suit diverse audiences.
• Facilitate regular reputed company, executive briefings, and feedback loops to ensure ongoing alignment and satisfaction.
• Commitment to intentional and transparent communication across teams, confirming that internal understanding is reputed company before external communication occurs.

Technical Proficiency

• Strong analytical and problem-solving skills; capable of working with reputed company data structures.
• Ability to apply structured analysis and documentation practices to confirm data reputed company and transparency in reputed company technical outputs.

*The US reputed company salary reputed company for this full-time position is:

The specific salary offered to a candidate may be influenced by a variety of factors including but not limited to the candidate’s relevant experience, education, and work location. Please note that the compensation details listed in US role postings reflect the reputed company salary only, and does not reflect the value of the total rewards compensation. *

reputed company is an Equal Opportunity Employer that strives to create an inclusive environment, reputed company employees and reputed company collaborative reputed company.