IRF Compliance Analyst
Role Overview
-Review and validate client-submitted documentation to support IRF claims processing.
-Ensure completeness, accuracy, and consistency of claim records and supporting evidence.
-Upload, organize, and maintain documentation within designated claims management systems and repositories.
-Execute end-to-end IRF claims review and validation activities in accordance with established policies, procedures, and service levels.
-Analyze client-submitted documentation and transaction data to determine claim eligibility and support claim adjudication.
-Investigate claim exceptions, discrepancies, and processing issues, escalating matters as appropriate.
-Partner with regional stakeholders, operations teams, product teams, and compliance functions to resolve claim-related inquiries.
-Maintain accurate records, audit trails, and supporting documentation for claims decisions.
-Develop and maintain reporting, dashboards, and KPIs to monitor claims inventory, processing efficiency, and program performance.
-Identify opportunities to improve operational controls, process efficiency, and automation within the claims lifecycle.
periodic reviews, quality assurance activities, and strategic initiatives related to interchange compliance and claims operations.
This is a hybrid position.
Expectation of days in the office will be confirmed by your Hiring Manager.
Full Job Posting
Qualifications
- 2-4 years of experience post MBA, preferably in data science background
- Visa is an EEO Employer
- Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. Visa will also consider for employment qualified applicants with criminal histories in a manner consistent with EEOC guidelines and applicable local law.
About Visa
Visa is a global payments technology company that connects consumers, businesses, banks, and governments in over 200 countries through its electronic payment network, VisaNet.
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