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Business Advisor – Carelon Integrity

Job in Frankfort, Franklin County, Kentucky, 40601, USA
Listing for: Jobtailor
Full Time position
Listed on 2026-09-12
Job specializations:
  • Business
    Business Analyst
Salary/Wage Range or Industry Benchmark: 55000 - 75000 USD Yearly USD 55000.00 75000.00 YEAR
Job Description & How to Apply Below
  • Assist management and the organization in bridging the gap between current and desired business performance levels
  • Balance short-term business needs with long-term perspectives on success
  • Help build and support the company’s change network
  • Support Payment Integrity-related process enhancements
  • Provide data entry and documentation support for Payment Integrity execution roles
  • Assist business units in implementing and tracking key activities
  • Communicate information through newsletters, dashboards, and presentations
  • Present claims accuracy insights and Payment Integrity program updates
  • Promote the benefits of the function within the region and throughout the company
  • Contribute to improving payment accuracy and reducing errors
Requirements
  • Requires a BA/BS and minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background
  • Expertise in preparing executive-facing PowerPoint presentations
  • Ability to synthesize complex information into clear visuals
  • Experience supporting Payment Integrity, Claims, or Healthcare Operations functions
  • Strong data entry accuracy
  • Documentation management
  • Ability to track Payment Integrity execution activities
  • Familiarity with claims processing, over payment identification, audit workflows, or financial accuracy processes
  • Ability to interpret and communicate Payment Integrity metrics, trends, and operational updates
  • Proficiency with reporting or workflow tools such as Excel, SharePoint, Tableau, or internal Payment Integrity platforms
  • Strong attention to detail
  • Ability to manage multiple data sources, queues, or work streams
  • Experience collaborating with Claims, SIU, Clinical Review, and Operations teams
  • Demonstrated ability to support process improvements, change initiatives, and performance optimization efforts
  • Must reside within a reasonable commuting distance from a posting location unless an accommodation is granted as required by law
Core Competencies

Demonstrates expertise in Payment Integrity processes, including claims accuracy and documentation management, while effectively communicating insights through executive presentations and data visualization. Proven ability to support process improvements and manage multiple work streams to enhance business performance.

Highest-signal resume keywords
  • Payment Integrity Support
  • Claims Processing Experience
  • Executive-Facing PowerPoint Presentations
  • Data Entry Accuracy
  • Reporting Tools Proficiency
Hard Skills
  • Payment Integrity
  • Claims Processing
  • Documentation Management
  • Data Entry Accuracy
  • Process Improvement
  • Performance Optimization
  • Change Initiatives
  • Financial Accuracy
  • Audit Workflows
  • Overpayment Identification
Soft Skills
  • Attention to Detail
  • Communication Skills
  • Collaboration
  • Synthesis of Complex Information
  • Ability to Manage Multiple Work streams
Industry Keywords
  • Healthcare Operations
  • Payment Integrity Metrics
  • Claims Accuracy Insights
  • Operational Updates
Tools & Technologies
  • Excel
  • Share Point
  • Tableau
  • Internal Payment Integrity Platforms
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