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Operations Associate Payment Integrity

Date Posted: Apr 18, 2026

Job Detail

  • location_on
    Location United States of America
  • desktop_windows
    Job Type: Contract
  • schedule
    Shift: First Shift (Day)
  • analytics
    Career Level: Department Head
  • group
    Positions: 1
  • calendar_view_day
    Experience: Fresh
  • male
    Gender: Female
  • school
    Degree: Non-Matriculation
  • calendar_month
    Apply Before: Jun 17, 2026

Job Description

Overview

Clover Health is seeking an Operations Associate for its Payment Integrity team, which plays a crucial role in ensuring that claims are processed accurately and in compliance with medical standards. This position supports cost containment efforts while enhancing relationships with providers and maintaining high-quality service for members.

Key responsibilities

  • Facilitate the aggregation of high-volume claim batches for reprocessing
  • Utilize advanced data management and spreadsheet techniques to merge, review, and validate claims
  • Perform audits to ensure accuracy of batch-reprocessed claims
  • Conduct comprehensive reconciliations for expected adjustments
  • Support coordination between internal and external stakeholders

Required skills

  • Data analysis
  • Claim processing
  • Compliance knowledge
  • Cost containment experience
  • Provider relations expertise
  • Quality assurance skills
  • Collaboration and teamwork abilities
  • Financial management knowledge
  • Operations support

What the company offers

Not specified in the original listing.

Company Overview

United States of America

Clover Health is dedicated to reinventing health insurance by prioritizing health and preventive care for seniors. They provide high-quality, affordable healthcare plans and utilize data technology to enhance physician decision-making. Read More

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