9 open positions available
Provide technical support and troubleshoot complex enterprise issues across storage, networking, and multi-platform environments. | Experience in technical support, troubleshooting, escalation management, and cross-functional collaboration in enterprise IT environments. | Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Lyric, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience. Interested in shaping the future of healthcare with AI? Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. Applicants must already be legally authorized to work in the U.S. Visa sponsorship/sponsorship assumption and other immigration support are not available for this position. We're a company at the intersection of FinTech and Healthcare, committed to simplifying healthcare payment integrity and creating value for health insurers, healthcare providers, and consumers. We're not a startup, but we move like one when it matters. Right now, we're starting on a large modernization of our payment integrity platform: ripping out legacy .NET, rebuilding around clean APIs, fixing data bottlenecks, and getting the product ready for scale on FullStack Engineer to build intuitive, performant web experiences backed by scalable, event driven services. You’ll own end to end delivery—from modular Angular frontends (including micro-frontend strategies) to resilient .NET microservices—working closely with product, UX, DevOps, and QA to ship customer delighting features at scale. If you thrive in fast-paced environments, care deeply about clean architecture and DX, and enjoy solving complex UI/UX and distributed systems challenges, this role is for you. Here's what makes this role different: you're not just a .NET engineer who "also knows AI." We want someone who has already figured out that tools like Cursor, Claude Code, and Codex aren't toys - they're force multipliers. You'll use AI agents every day to tear through migrations, refactors, and test coverage that would take a traditional team weeks. But you also know when the AI is wrong, when to step in, and how to keep quality high. Think of it as having a junior engineer with infinite energy and zero judgment - your job is to supply the judgment. ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES Ship modernization work at a pace that surprises people This is your superpower. You'll: Use AI agents (Cursor, Claude Code, Codex) to blow through framework upgrades, refactors, API extraction, test scaffolding, and documentation - while catching hallucinations and preventing regressions before they hit a PR. Build reusable playbooks the team can actually follow: prompt templates, repo-level agent instructions, migration checklists, review heuristics, and clear "definition of done" standards for AI-assisted changes. What success looks like: You measurably move the needle - more modules migrated per sprint, faster PR turnarounds - without a spike in production bugs. The team gets better because of you: PRs are clearer, test coverage grows, documentation stays current, and the same mistakes stop repeating. Modernize a real .NET + SQL Server stack into something you'd be proud of You'll: Upgrade legacy services to current .NET (LTS where it makes sense), untangling architecture boundaries and fixing the performance issues that have been "known" for years. Push toward a proper API-layer architecture - RESTful, versioned - built for correctness and maintainability, not just "it works." Get your hands dirty with SQL Server: query performance, indexing, transactional correctness. If there are data pipeline needs (Kafka, etc.), you'll help build those too. What success looks like: Legacy surface area shrinks sprint over sprint. Critical paths live in modern code. Fewer "oh, that's still in the old system" conversations. APIs get faster and more reliable. Database hot spots stop waking people up at night. Own it like it's yours - especially because this is healthcare You'll: Build with security and privacy as defaults, not afterthoughts. Least privilege, safe data handling, the works. This is healthcare - getting it wrong isn't an option. Put real quality guardrails in place: automated tests that actually catch things, CI that blocks bad changes, structured logging, observability that tells you what's happening before users do. Review code thoughtfully, have honest architectural conversations, and raise the bar without being a jerk about it. What success looks like: Fewer severity-1 incidents. When something does go wrong, root cause takes hours, not days. Automated test coverage grows meaningfully on modernized code. The team stops relying on "just test it manually." Work with real humans to ship things that matter You'll: Partner with analysts, stakeholders, and other engineers to turn business problems into working software - not just technically correct software, but software that actually solves the problem. Help build delivery plans that are honest about trade-offs. "Right" vs. "right now" is a real tension - you'll help the team navigate it with pragmatic milestones. What success looks like: Delivery is predictable. Customer onboarding milestones are met. Features ship with confidence, not crossed fingers. REQUIRED SKILLS & EXPERIENCE 5+ years building and shipping production systems. Not side projects - real software with real users solving skills; able to work independently and collaboratively in fastmoving teams Some C# and modern .NET experience (Core and beyond). Especially in large codebases and you've done meaningful refactoring and migration work, not just greenfield. Strong SQL Server chops - schema design, query tuning, performance troubleshooting. You've worked on data-heavy applications where the database wasn't an afterthought. Cloud experience with Azure and/or AWS. Azure is particularly relevant here. API design experience - you've built and maintained service-oriented architectures with real versioning, auth, reliability, and testing practices. You actually use AI coding tools as a daily driver. Cursor, Claude Code, Codex, or similar - and not just for autocomplete. You've used agents for multi-file refactors, migrations, test generation, and review workflows. You have opinions about what works and what doesn't. You communicate clearly. Good PR descriptions, straightforward design docs, pragmatic collaboration, low ego. We don't need a rockstar - we need someone the team trusts. PREFERRED QUALIFICATIONS You've actually done a legacy ASP.NET / .NET Framework modernization before. You know where the bodies are buried and you have the scars to prove it. Bonus points for Azure modernization patterns. Experience with distributed systems tooling - Kafka, event-driven architectures, or working with Postgres alongside SQL Server. Front-end experience with Angular and/or React/Next.js. You've helped establish agent-friendly engineering practices: writing repo instructions that AI tools can follow, breaking work into agent-sized tasks, setting up CI guardrails for AI-generated code, feature flags, canary deployments - any part of the progressive delivery toolkit. Background in regulated domains (healthcare, fintech, payments) where "move fast and break things" will get you fired. ***The US base salary range 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 base salary only, and does not reflect the value of the total rewards compensation. *** Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success. Our ambition is to be an AI-first platform sitting at the intersection of healthcare and fintech, providing simplified consumer and patient solutions to plans and providers in the wake of value-based care while continuously identifying the unmet needs of customers
Conduct moderate-to-complex COB investigations, verify coverage details, and update records to ensure accurate claim processing. | Minimum of 8 years of healthcare experience in COB or payment integrity, advanced Excel skills, and knowledge of COB rules and claim workflows. | Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Lyric, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience. Interested in shaping the future of healthcare with AI? Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. Applicants must already be legally authorized to work in the U.S. Visa sponsorship/sponsorship assumption and other immigration support are not available for this position. The Sr. Payment Integrity Specialist (COB) serves as a subject matter expert within the Coordination of Benefits (COB) program, leading moderate-to-complex investigations to validate other insurance coverage, resolve conflicting eligibility information, and establish the correct order of liability (primary vs. secondary payer) to prevent and recover improper claim payments. This role performs hands-on casework in a high-volume environment including outreach, documentation, and system updates, while applying advanced analytical skills to interpret claims and eligibility data, identify trends and false positives, and drive process and reporting improvements that improve accuracy and outcomes for the COB program. ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES Investigation and verification Review, prioritize, and independently work assigned COB leads (automated and manual), including moderate-to-complex and high-dollar cases, to determine verification steps and next actions. Investigate and validate coverage details (payer, plan type, subscriber relationship, policy indicators, effective/termination dates) using internal systems, payer portals, EOBs/claim responses, and other approved data sources. Apply COB rules and guidelines, including CMS and NAIC guidance as applicable, to determine the correct order of liability and document the rationale for the primacy determination. Reconcile discrepancies across sources (eligibility feeds, member/group data, claim history, and third-party responses) and drive cases to a clear, audit-ready determination; escalate edge cases per policy. Outreach, documentation, and system updates Contact insurance carriers, employers, clearinghouses, providers, and other third parties as needed to confirm or clarify coverage information and obtain supporting evidence. Create clear, detailed, and accurate case notes that capture verification steps, evidence, and outcomes in internal tools to support audits and downstream recovery/reprocessing. Update eligibility/COB records and coordination rules based on verified information and confirm updates are applied correctly to reduce downstream adjudication errors and abrasion. Prepare and evaluate documentation needed for inquiries, client/provider disputes, and appeals related to determinations, as assigned. Quality, SME support, and operational ownership Perform quality checks on your work and as assigned, peer outputs prior to submission/export to ensure accuracy, completeness, and compliance with internal standards and regulatory expectations. Serve as a COB SME: provide knowledge share, mentoring, and coaching to Specialists; support new hire onboarding and training as needed. Support inventory management by helping to isolate and distribute work and by proactively flagging capacity, risk, and prioritization needs to leadership. Meet or exceed established productivity, turnaround time, and quality/audit standards while managing a high-volume case queue with a high degree of autonomy. Process improvement and analytical contribution Identify and solve problems by surfacing errors and overpayments, documenting root causes, and recommending corrective actions that reduce rework and improve yields. Track outcomes and error categories, identify drivers of recurring issues and false positives, and recommend opportunities to streamline research, improve data quality, and enhance logic. Use advanced Excel and other tools to support ad hoc analysis (e.g., trend review, inventory quality checks, and performance insights); develop simple trackers or reporting views to support operational decisions. Demonstrate strong understanding of query and filter construction (and/or similar investigative tooling) to identify opportunities; partner with stakeholders to test and implement workflow or tool enhancements and measure impact. REQUIRED QUALIFICATIONS Minimum of eight (8) years of related healthcare experience (e.g., COB/TPL, eligibility, claims operations, billing, recovery, or payment integrity). Minimum of eight (8) years of experience performing COB investigations and/or payment integrity casework, including independent ownership of moderate-to-complex inventories. Advanced proficiency with Excel and comfort working with large data sets and multiple systems/portals; ability to produce clear summaries and operational insights. Working knowledge of coordination of benefits rules, primary/secondary payer logic, coverage hierarchy, and order-of-liability concepts; understanding of CMS and NAIC guidance as applicable. Demonstrated ability to analyze and reconcile information across multiple sources (eligibility feeds, member/group data, claim history, payer portals, EOBs/claim responses). Ability to work within established productivity and quality metrics while prioritizing workload with minimal supervision. Strong problem-solving skills with the ability to resolve conflicting or incomplete information and escalate appropriately. Ability to maintain confidentiality and comply with HIPAA and data security standards. PREFERRED QUALIFICATIONS Bachelors degree in business or healthcare/related field Experience performing quality review/quality control and providing feedback or coaching to improve team outcomes. Demonstrated process improvement experience (e.g., SOP development, workflow redesign, training updates) with measurable impact on accuracy, turnaround time, or false positives. Familiarity with eligibility data workflows, payer portals, and third-party data sources used in COB validation. Working knowledge of claim adjudication workflows and payment rules. Experience building queries/filters or using reporting tools to identify opportunities; basic SQL or query-tool proficiency is a plus. Experience in high-volume, SLA-driven operations teams; comfort operating in a metric-driven environment. Creative thinker with an entrepreneurial spirit ***The US base salary range for this full-time position is: $85,018.00 - $127,526.00 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 base salary only, and does not reflect the value of the total rewards compensation. *** Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success. Our ambition is to be an AI-first platform sitting at the intersection of healthcare and fintech, providing simplified consumer and patient solutions to plans and providers in the wake of value-based care while continuously identifying the unmet needs of customers
Designing and implementing scalable, secure, and maintainable systems, collaborating across teams, and mentoring engineers. | Requires 8+ years of software engineering experience, proficiency in backend languages like Java, Go, or Python, and knowledge of distributed systems, APIs, databases, and cloud infrastructure. | Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Lyric, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience. . Interested in shaping the future of healthcare with AI? Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. The Staff Software Engineer drives the design and implementation of mission-critical systems across our platform. As a high level individual contributor, this position leads architectural decisions, influences engineering standards, and mentors fellow engineers while remaining hands-on in building scalable, high-performance software. ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES Architect and implement core services, systems, and APIs with a focus on scalability, security, and maintainability Serve as a technical leader across multiple projects, providing guidance on system design, coding best practices, and performance optimization Collaborate cross-functionally with product managers, designers, and other engineers to deliver high-quality solutions Lead design reviews, code reviews, and contribute to technical documentation and RFCs Investigate and resolve critical issues in production systems, ensuring reliability and uptime Drive adoption of engineering best practices, tools, and frameworks across teams. Mentor and coach junior and mid-level engineers, helping them grow in their technical careers REQUIRED QUALIFICATIONS Minimum of eight (8) years of software engineering experience, including designing and shipping large-scale systems Deep proficiency in one or more backend or full stack languages (e.g. Java, Go, Python, TypeScript) Strong knowledge of distributed systems, API designs, databases (SQL and NoSQL), as well as cloud infrastructure (e.g., AWS, GCP, or Azure) Experience with CI/CD pipelines, container orchestration (e.g., Kubernetes), and observability practices PREFERRED QUALIFICATIONS Excellent problem solving skills and a collaborative mindset Strong communication skills with the ability to influence technical direction and communicate effectively with stakeholders Experience in a high-growth tech company or fast-paced startup environment Familiarity with event-driven architectures, streaming systems (Kafka, Pub/Sub), or microservice patterns Background in platform engineering, DevOps, or site reliability Contributions to open source projects or technical publications ***The US base salary range 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 base salary only, and does not reflect the value of the total rewards compensation. *** Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success. Our ambition is to be an AI-first platform sitting at the intersection of healthcare and fintech, providing simplified consumer and patient solutions to plans and providers in the wake of value-based care while continuously identifying the unmet needs of customers
Drive the strategy, development, and management of pre-pay healthcare products, collaborating with cross-functional teams to deliver innovative solutions. | 8+ years in Product Management, 3+ years in healthcare, with experience in payment integrity solutions and relevant certifications. | Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Lyric, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience. . Interested in shaping the future of healthcare with AI? Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. This role is responsible for driving the strategy, development, and management of our pre-pay products. This role collaborates closely with cross-functional teams including engineering, design, marketing, sales, and customer support to deliver innovative solutions that meet the evolving needs of our healthcare provider and payer customers. ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES Product Strategy: Understand and execute the product strategy for pre-pay solutions, aligning with overall company objectives and market demands. Market Analysis: Conduct comprehensive market research and analysis to identify trends, opportunities, and competitive threats in the payment integrity industry. Product Roadmap: Create and maintain a clear and prioritized product roadmap based on market needs, customer feedback, and business priorities evaluated against resource availability. Feature Definition: Work closely with stakeholders to define product features and requirements, ensuring they are detailed, achievable, and aligned with customer expectations. Cross-functional Collaboration: Collaborate effectively with engineering, design, marketing, sales, and customer support teams to drive product development and launch activities. Think strategically while executing tactically. Product Development: Manage the entire product lifecycle from concept to launch, including gathering and prioritizing product and customer requirements, defining the product vision, and working closely with engineering, sales, and support to ensure revenue and customer satisfaction goals are met. Risk Management: Identify potential risks and issues early in the development process and work with stakeholders to mitigate them effectively. Customer Focus: Develop a deep understanding of customer needs and pain points through direct interaction, surveys, and data analysis. Use insights to inform product decisions and enhancements. Compliance and Security: Ensure that all payment integrity products comply with relevant regulations and security standards (e.g., HIPAA, PCI-DSS). Measurement and Optimization: Define and monitor key product metrics to measure success and identify opportunities for continuous improvement. Implement strategies to optimize product performance and user experience. Product Evangelism: Serve as the internal and external evangelist for product offering, working with sales, marketing, and customer support to help them understand the product positioning, key benefits, and target customer. REQUIRED QUALIFICATIONS Required (quantifiable from resume/application): Bachelor’s Degree 8 + yrs of experience in Product Management 3 + Years Healthcare industry experience PREFERRED QUALIFICATIONS Master’s in healthcare or technology related field PO/PM Certification Pragmatic Marketing Certification Experience in Payment Integrity Solutions ***The US base salary range for this full-time position is: $146,910.00 - $220,366.00 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 base salary only, and does not reflect the value of the total rewards compensation. *** Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success. Our ambition is to be an AI-first platform sitting at the intersection of healthcare and fintech, providing simplified consumer and patient solutions to plans and providers in the wake of value-based care while continuously identifying the unmet needs of customers
Lead end-to-end technical implementations and integrations for healthcare clients, collaborating with engineering and customer success teams. | Extensive experience in enterprise system integration, API development, cloud platforms, and healthcare data standards, with a focus on successful enterprise implementations. | Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Lyric, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified, and a recipient of the 2025 CandE Award for Candidate Experience. Interested in shaping the future of healthcare with AI? Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. Applicants must already be legally authorized to work in the U.S. Visa sponsorship/sponsorship assumption and other immigration support are not available for this position. As a Senior Implementation Engineer, you will play a key role in delivering successful client implementations and system integrations. You’ll use your technical expertise to deploy, configure, and optimize Lyric’s solutions for enterprise healthcare clients. In this role, you’ll collaborate closely with engineering, data, and customer success teams to ensure seamless integration and high-quality outcomes. You will be hands-on technology, and supporting clients through complex integration projects. Applicants must already be legally authorized to work in the U.S. Visa sponsorship / sponsorship assumption and other immigration support are not available for this position. Responsibilities Support and lead end-to-end technical implementations for enterprise healthcare clients—from discovery and requirements gathering through deployment and go-live. Collaborate closely with product engineering, data engineering, and customer success teams to ensure client implementation needs are reflected in the technical solution. Contribute to the development of implementation best practices, including process improvements, automation, and documentation. Troubleshoot technical issues during integrations and work proactively to ensure smooth deployments. Participate in continuous improvement initiatives to enhance delivery efficiency and solution quality. Provide guidance and technical support to junior team members when needed. Required Qualifications: Bachelor’s degree in Software Engineering or a related field or 12 years relevant experience. 8+ years of experience in combination of technical implementation, systems integration, and client-facing roles with a proven record of successful enterprise implementations 5+ years of experience with Enterprise Application Integration (EAI) and service-oriented architectures, preferably in healthcare, fintech, or SaaS environments 5+ years of hands-on experience with API integrations, data migrations, and system-to-system connectivity 5+ years working with cloud platforms (AWS, GCP, or Azure) and cloud-based deployment architectures 3+ years of experience with data storage solutions (SQL and NoSQL) and data transformation processes 3+ years coding in one or more languages (.NET preferred) Preferred Qualifications: Familiarity with containerization (Docker, Kubernetes) and Infrastructure as Code tools (Terraform, CloudFormation). Experience with monitoring and observability tools for production systems Knowledge of healthcare data standards and regulations (HIPAA, HITRUST, HL7, FHIR) is a plus Background in healthcare payer operations or claims processing systems is preferred Relevant certifications in cloud platforms or healthcare technology standards is a plus ***The US base salary range for this full-time position is: $122,425.00 - $183,638.00 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 base salary only, and does not reflect the value of the total rewards compensation. *** Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success. Our ambition is to be an AI-first platform sitting at the intersection of healthcare and fintech, providing simplified consumer and patient solutions to plans and providers in the wake of value-based care while continuously identifying the unmet needs of customers
The Payment Integrity Analyst will support post-payment customer deliverables through data analysis and process automation. They will engage with customers and internal partners to enhance payment integrity services. | Candidates must have at least 1 year of experience in SQL programming and auditing medical claims. A bachelor's degree in a related field and experience with automation tools are preferred. | Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Lyric, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified. Interested in shaping the future of healthcare with AI? Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. Applicants must already be legally authorized to work in the U.S. Visa sponsorship/sponsorship assumption and other immigration support are not available for this position. The Data Analyst will support excellence of execution with post payment customer deliverables through data analysis, enhancing data models and creating/improving automation of processes. In addition, the Data Analyst will engage with customers and internal partners to deliver services to Lyric post payment integrity customers. Responsibilities Research new customer specific value opportunities; create SQL queries, analyze data; size opportunity and present potential value back to leaderships (40%) Improve existing models by analyzing model performance against benchmarking, identifying gaps and providing recommendations. (10%) Identify opportunities for further automation of repetitive tasks. (10%) Support the payment integrity team in a variety of business processes including but not limited to processing medical insurance claim overpayments through recovery (40%) Review claims for missing or incomplete information, calculate payment, or validation of identified overpayments. Reconcile submission response files, work with key stakeholders to resolve issues and ensure outstanding response pipeline is current. Process overpayments (provider refunds) requests, support notification letters process. Recognize and document system issues. Keep abreast of the changes in regulations, program policies and current processing procedures. Ensure legal compliance by following company policies, client policies, procedures, guidelines, as well as state and federal regulations. Collaborate with clients to resolve provider disputes and inquiries Maintain productivity goals and standards set by the department Process overpayments (provider refunds, adjustments, offsets) request Required Qualifications: 1+ years of SQL programming/queries, as well as advanced excel experience 1+ Years’ experience auditing medical claims to identify improper payments as a Payment Integrity Vendor or within a Health Plan’s Payment Integrity team. 1+ years of experience performing data analytics with large data sets Preferred Qualifications: Bachelors degree in business or healthcare/related field 1+ years of experience with automation tools (e.g. UIPath) 1+ years of combined experience in healthcare, such as prior work in health insurance, claims processing or adjudication, or fraud, waste and abuse detection 1+ years of experience in medical billing codes including but not limited to CPT, ICD-10-PCS, ICD-10-CM, HCPCS, and NDC, as well as an understanding of medical terminology, and prospective payment systems including DRG, OPPS, and MIPS Creative thinker with an entrepreneurial spirit Strong verbal and written communication skills Experience in various claim payment methodologies for professional, facility, and ancillary providers Working knowledge of payment integrity auditing concepts ***The US base salary range for this full-time position is: $23.65 - $35.48 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 base salary only, and does not reflect the value of the total rewards compensation. *** Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success. Our ambition is to be an AI-first platform sitting at the intersection of healthcare and fintech, providing simplified consumer and patient solutions to plans and providers in the wake of value-based care while continuously identifying the unmet needs of customers
Manage day-to-day distribution center operations including shipping, receiving, inventory control, route management, employee leadership, and cost control. | Requires experience in distribution or transportation environment, leadership and motivational skills, proficiency with Microsoft Office, and ability to manage a team and ensure safety compliance. | Compensation Data NA Company Overview With $5 billion in revenue and 3,500+ employees in the U.S. and Mexico, TBC Corporation is a leader in the mobility industry and one of North America’s largest marketers of automotive replacement tires through wholesale and franchise operations. TBC serves wholesale customers in the United States, Canada and Mexico through TBC Brands, NTW, TBC International, and TBC de Mexico. Additionally, TBC responds to the needs of consumers in search of total car care at more than 465 franchised tire and automotive service centers under Big O Tires®. TBC is headquartered in Palm Beach Gardens, Florida. TBC markets on a wholesale basis to regional tire chains and distributors serving independent tire dealers throughout the US, Canada, and Mexico. TBC has 20 proprietary brands of tires specializing in passenger, commercial, farm and specialty tires. In 2005, TBC Corp. was purchased by Sumitomo Corporation of America (SCOA). SCOA is the largest subsidiary of Sumitomo Corporation, one of Japan’s major integrated trading and investment business enterprises. In 2018 Michelin, the largest tire manufacturer in Europe, invested in the company which is now a 50:50, privately held joint venture between Sumitomo and Michelin. Our values are the foundation of our work, how we interact with each other, and the strategies we employ to fulfill our purpose. These are the practices we use every day – in everything we do: • Integrity - We act honestly because nothing is more important than our reputation. • Teamwork - We are better together. • People-Focused - We put people first – our Associates, customers, franchisees, and partners – and cultivate a respectful, collaborative, and inclusive culture, top to bottom, inside and out. • Accountability - We own our actions and decisions; we do what we say we are going to do. • Leave Everything Better - We innovate to improve everything we touch, and we take actions now to protect the future. Description Our DC Operations Manager are responsible for managing all day-to-day operations at the DC, deliver superior service, manage cost, support sales and marketing efforts to increase sales and improve profitability. Provide leadership, coaching and training to all personnel while promoting TBC’s core values. Job Responsibilities • Oversee all aspects of DC operations including shipping, receiving, inventory control and route management • Responsible for deploying Company Vision, Purpose and Values • Meet or exceed TBC’s performance standards for quality and SLA – service level agreements to our customers. • Responsible for the protection of company assets which includes Inventory, Equipment, and facilities. • Maximize DC Cost Control in relation to all Variable Expenses • Ensure the timely and accurate completion of all picking, receiving, put away, load/ship of all orders, product returns, and ensuring Inventory Control functions. • Responsible for Employee Engagement and maintain solid employee relations through regular communications and administration of the company’s Human Resource policies. • Implement appropriate company and regulatory training to ensure that staff is equipped to perform assigned duties. • Maintains the facility, equipment and vehicles and will resolve any issues which may interfere with the safe, efficient, and least cost operation of the Distribution Center. • Regularly review security systems to ensure proper operation and utilization. • Ensure a safe work environment is present at all times and all employees abide by safety guidelines • Responsible for all HR related Items • Manage and develop a high-performing team, including hiring, training, and performance management, to ensure the smooth and effective operation of the distribution center • Operate MHE and Inventory as needed • Other duties as needed or assigned Additional Responsibilities Qualifications • Safety 1st Mentality • Proficient in computer programs including Microsoft Office, Excel, etc. • Team player willing to do what is asked of • A 4-year degree in Logistics, Business or other related disciplines is preferred or equivalent experience in a distribution or transportation environment. • management experience including but not limited to leadership and motivational ability, time management and organizational skills, training, coaching and counseling preferred • Ability to work well under pressure (conflicting priorities, absenteeism etc.) and handle multiple tasks. • Strong verbal and written communication skills. • Must be able to repetitively lift up to 50 pounds while bending and twisting • Computers experience including Microsoft Office Word, PowerPoint, Excel, Outlook, etc. • SAP and Routing Software experience a plus. • Exceptional Customer Service Skills • High level of professional integrity • Must maintain a current driver’s license • Ability to work a flexible schedule including nights holidays and weekends • 24/7 access to cell phone, email and security system in case of an emergency • Must be able to pass a Criminal Background Check and Pre-Employment Drug Screen Benefits • Market competitive compensation • 401(k) and Roth with company match. Immediate 100% vesting • Comprehensive benefits including medical, dental and vision • Company paid short term disability and employer subsidized long term disability • Company paid life insurance • Discounted tire purchasing • Tuition reimbursement • Employee assistance program • Generous paid vacation and paid time off • Customizable voluntary benefits • and More!!! TBC Corporation is an Equal Opportunity Employer and maintains a Drug-Free Work Environment. #joinourteam #LI-DNI #tbccorp #tbc #ntw Mission Critical Competencies TBC seeks team members who excel in demonstrating our critical competencies to drive organizational capability. In this spirit we view the following as mission critical for this role: • Strategic Mindset: seeing ahead to future possibilities and translating them into breakthrough strategies. • Action Oriented: Taking on new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm. • Cultivates Innovation: Creating new and better ways for the organization to be successful. • Collaborates: Building partnerships and working collaboratively with others to meet shared objectives • Customer Focus: Building strong customer relationships and delivering customer-centric solutions. • Develops Talent: Developing people to meet both their career goals and the organization's goals. • Ensures Accountability: Holding self and others accountable to meet commitments. • Drives Engagement: Creating a climate where people are motivated to do their best to help the organization achieve its objectives. • Communicates Effectively: Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences. • Instills Trust: Gaining the confidence and trust of others through honesty, integrity, and authenticity. • Change Management: effective Sponsorship, Change Agent and influencing skills. Adaptive, agile, flexible, open minded. Proven ability to build cross-functional commitment, lead, simplify and scale complex dynamic organizations through transformational change.
Analyze large healthcare claims datasets, develop BI reports, partner with Data Science to build predictive models, and support business decision-making. | 10+ years manipulating data and building statistical models with SQL, 7+ years healthcare claims experience, proficiency in BI tools, and strong communication skills. | Lyric is an AI-first, platform-based healthcare technology company, committed to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling more efficient use of resources to reduce the cost of care for payers, providers, and patients. Lyric, formerly ClaimsXten, is a market leader with 35 years of pre-pay editing expertise, dedicated teams, and top technology. Lyric is proud to be recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified. Interested in shaping the future of healthcare with AI? Explore opportunities at lyric.ai/careers and drive innovation with #YouToThePowerOfAI. The Forensic Data Analyst, Specialist plays a pivotal role in advancing our products and services by shaping solution design and supporting strategic decision-making. This individual collaborates closely with engineers, clinical experts, payment professionals, and business operations leaders to develop reporting and analyze large-scale healthcare claims and clinical datasets, as well as to generate new analytic content aimed at ensuring claims are paid accurately. By leveraging advanced coding, analytic reporting, and predictive modeling, the Forensic Data Analyst, Specialist uncovers actionable insights that drive innovation and improve outcomes across the organization. ESSENTIAL JOB RESPONSIBILITIES & KEY PERFORMANCE OUTCOMES Work cross functionally to identify opportunities for leveraging company data to drive business solutions Mine and analyze data from healthcare claim databases to drive optimization and improvement of product development, sales, marketing techniques and business strategies Design and develop business intelligence reporting suite for internal and external consumption Author new analytic content aimed at ensuring health plans pay accurate and reasonable amounts for claims submitted on behalf of their members Partner with Data Science and Engineering to develop custom complex SQL queries and algorithms to apply to data sets Partner with Data Science and Engineering to create predictive modeling to support business reporting and decision making Coordinate with different functional teams to implement models and monitor outcomes Develop processes to monitor and analyze model performance and accuracy of results REQUIRED QUALIFICATIONS Minimum of 10 years experience manipulating data sets and building statistical models through SQL, and more advanced technologies Minimum of 7 years experience with healthcare data and standard UB/HCFA claim fields Experience using and developing in enterprise level business intelligence tools (e.g. PowerBI, Sigma, Tableau, Domo) PREFERRED QUALIFICATIONS Bachelors degree in business or healthcare/related field Excellent written and verbal communication skills for coordinating across teams and with customers Experience partnering with Data Science teams to ideate algorithms and models, using statistical computer languages (SQL, Python, R) to manipulate data and generate insights from large data sets Experience working in project management tools (Jira, Confluence) employing proficiency in time management abilities Strong problem-solving skills with an emphasis on product development Drive to learn and master new technologies and techniques Experience building, and delivering, compelling presentations in PowerPoint (or similar) Experience across multiple Payment Integrity product areas (e.g. Edits, Data Mining, Coordination of Benefits, SIU, etc) #LI-DNI ***The US base salary range for this full-time position is: $146,910.00 - $220,366.00 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 base salary only, and does not reflect the value of the total rewards compensation. *** Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success. Our ambition is to be an AI-first platform sitting at the intersection of healthcare and fintech, providing simplified consumer and patient solutions to plans and providers in the wake of value-based care while continuously identifying the unmet needs of customers
The Senior Data Analyst conducts and directs the analysis of business problems to be solved with automated systems, engaging with clients to develop analyses for software evaluation and claims editing optimization. This role leads analytic engagements for a portfolio of clients, collaborating with internal teams to design analyses that meet customer needs. | Candidates must have 6+ years of experience in healthcare claims operations and 3+ years in healthcare claims coding and processing. A strong understanding of SQL coding and HIPAA compliance is also required. | Lyric, formerly ClaimsXten, is a leading healthcare technology company, committed to simplifying the business of care. Over 30 years of experience, dedicated teams, and top technology help deliver more than $14 billion of annual savings to our many loyal and valued customers—including 9 of the top 10 payers across the country. Lyric’s solutions leverage the power of machine learning, AI, and predictive analytics to empower health plan payers with pathways to increased accuracy and efficiency, while maximizing value and savings. Lyric’s strong relationships as a trusted ally to customers resulted in recognition from KLAS as “true partner” and “excellent value for investment,” with a top score for overall customer satisfaction and A+ likelihood to recommend in their October 2023 Payment Integrity and Accuracy Report. Discover more at Lyric.ai. Applicants must already be legally authorized to work in the U.S. Visa sponsorship/sponsorship assumption and other immigration support are not available for this position. A Senior Data Analyst at Lyric conducts and directs the analysis of both internal and external business problems to be solved with automated systems. This position engages with clients to develop analyses for the purpose of pre-sale software evaluation, claims editing optimization, and/or ad hoc reporting. The role leads analytic engagements for a portfolio of clients, in conjunction with internal business intelligence to design analyses to meet customer needs while working independently with internal and external clients on complex problems. Senior Data Analysts are tasked with judgment within defined procedures and practices to determine appropriate actions. The position collaborates with analytics manager in conjunction with go-to-market, services, and solution design staff to analyze claim editing opportunities or software reporting problems and assists team in executing optimal analytic design. Key Job Functions: Works with clients, other analytics team members, product management, go-to-market, and services staff to design and execute claims editing solutions for analytic deliverables including, but not limited to, recurring reports, product optimization and savings opportunity analyses, and other ad-hoc analyses required by constituents. Facilitates all pieces of external and internal analytic engagements, such as claims data integrity review, data mapping, edit analysis using Excel, SQL, and PowerPoint. Executes complex analyses to aid in reporting and interpretation of analytical findings to build a customer solution roadmap and achieve maximum value from the Lyric suite of products and services. Compiles findings into a clear, concise, and actionable deliverable. Presents findings to customers and completes any necessary follow-up analysis. Manages customer portfolio of analytic engagements and deliverables, responding to any ad hoc requests on an ongoing basis. Basic Requirements: 6+ years experience in healthcare claims operations Experience with presenting to senior management level personnel both inside and outside the organization 3 + years of healthcare claims coding, including CPT/HCPCS and ICD10. 3 + years of healthcare claims processing, managed care operations, and healthcare data attributes 3 + years of SQL Coding ability Understanding of HIPAA & Data Security Compliance Travel up to 10% Preferred Qualifications: Bachelor’s Degree preferred Experience designing and developing healthcare analyses Understanding of claims editing software, Boolean logic, edit content dictionaries, etc. Understanding of claims processing systems (eg. Facets, Nasco, etc.) ***The US base salary range for this full-time position is: $102,021.00 - $153,032.00 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 base salary only, and does not reflect the value of the total rewards compensation. *** Lyric is an Equal Opportunity Employer that strives to create an inclusive environment, empower employees and embrace collaborative success. Our ambition is to be an AI-first platform sitting at the intersection of healthcare and fintech, providing simplified consumer and patient solutions to plans and providers in the wake of value-based care while continuously identifying the unmet needs of customers
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