Demo

Payment Integrity Content Policy Manager, Client-Facing

Rialtic, Inc.
Atlanta, GA Full Time
POSTED ON 2/13/2025
AVAILABLE BEFORE 5/8/2025

Job Description

Job Description

  • Please note that this role requires working EST hours and can only consider East coast candidates.

Rialtic is on a mission to create a better healthcare system by reducing administrative costs, increasing efficiency and empowering payers and providers to focus on delivering the best care possible. Our initial offering is a next-gen enterprise technology platform that will dramatically reduce complexity, save money and increase speed and accuracy for healthcare claims processing and adjudication. We have an ambitious roadmap to tackle some of the biggest problems across healthcare technology.

Founded in 2020, Rialtic has raised over $15mm from investors, including leading healthcare technology investor, Oak HC / FT. Come join our team to build the best technology in healthcare and change the way the healthcare industry operates.

The Role

This role is perfect for someone who is passionate about transforming healthcare technology through data-driven insights and strong client partnerships! You're excited at being involved in client-facing initiatives to drive the adoption of payment integrity policies, analyze claims data to prioritize high-value opportunities, and simplify complex medical coding and policy recommendations for diverse audiences. The ideal candidate is a confident communicator with expertise in claims analysis and analytics who can seamlessly pivot between leading meetings, presenting findings, and collaborating with stakeholders to deliver impactful results.

You will :

  • Understand how to interpret healthcare correct coding policies and claims edits
  • Explain healthcare policy edits to clients
  • Increase policy adoption and drive savings rates per client
  • Use data to make policy review recommendations
  • Oversee policy implementation including prioritizing policies to present
  • Attend client implementation meetings and serve as primary content spokesperson, point of contact, and coordinator to external and internal departments on client account(s)
  • Develop timelines for client creation requests and influence teams to meet deliverables
  • Ensure client policy requests are understood, addressed, and executed as determined
  • Know and report on client implementation and decision making trends
  • Analyze clients' adoption trends and compare to proof of concept results. Explore findings with clients.
  • Be accountable for gathering, updating, and explaining content policy review materials
  • Establish a process and methodology to prioritize policies to create based on savings
  • We're looking for someone who has :

  • 3-6 years of work experience in payment integrity with a health plan or claims editing vendor
  • Coding, Billing, and / or Auditing Credentials or any certified coding specialty
  • Advanced Google Suite skills
  • Deep knowledge of claims edits' top error reasons, client value, and analytics
  • Expert in interpreting medical policies and applying correct coding guidelines
  • Expertise in multiple medical coding and / or billing specialties
  • Expertise in professional and institutional claims
  • Experience explaining medical policies and payment accuracy to clients
  • Managed claims editing implementations
  • Strong verbal communication skills
  • Experience presenting on client calls, answering client questions, and negotiating client requests with internal resources.
  • At Rialtic, our values matter. They describe how we work together and how we want others to experience us. We live and breathe these values every day in service of our clients.

  • High Integrity
  • Do the right thing. Provide candid feedback. Be humble and respectful.
  • Customer Value Comes First
  • Delivering value to our customers is our North Star.
  • Work as One Team
  • Collaborative, inclusive environment to advance our mission.
  • Be Bold & Accountable
  • Speak up. Take accountability. Continually improve.
  • Pursuit of Excellence
  • Innovate, iterate and chase the best possible outcomes.
  • Take Care of Yourself & Others
  • Prioritize the health and wellbeing of yourself and your teammates.
  • About Rialtic's Benefits :

  • Freedom to work from wherever you work best and a home office stipend to make it happen
  • Meaningful equity and 401k matching
  • Unlimited PTO and wellness reimbursements
  • Comprehensive health plans with generous contribution to premiums
  • Mental and physical wellness support through TalkSpace, Teladoc, and One Medical subscriptions
  • We are headquartered in Atlanta, but we are remote-friendly.

    Don't meet every single requirement?

    Studies have shown that women and people of color are less likely to apply for jobs unless they meet every single qualification.

    At Rialtic, we are dedicated to building a diverse, inclusive, and authentic workplace. If you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyway. You may be just the right candidate for this or other roles.

    Rialtic is an equal-opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. We cannot access your personal Equal Employment Opportunity Commission information during the interview process. Rialtic is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. To request a reasonable accommodation, please let us know in your application or email us at Please take the necessary steps to allow listing of the Rialtic (@Rialtic.io) and Greenhouse (@Greenhouse.io) domains so that you receive all emails related to your application process. Also, please make sure to check your spam folder as emails from LifeLabs and / or Greenhouse can be marked as spam.

    TO ALL RECRUITMENT AGENCIES :

    Rialtic does not accept agency resumes. Please do not forward resumes to Rialtic employees or any other company location. Rialtic is not responsible for any fees related to unsolicited resumes and will not pay fees to any third-party agency or company that does not have a signed agreement with the Company for this specific role.

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    Job openings at Rialtic, Inc.

    Rialtic, Inc.
    Hired Organization Address Atlanta, GA Full Time
    We appreciate your interest in working for Rialtic! If you don't see a position that fits your career needs at this time...
    Rialtic, Inc.
    Hired Organization Address Atlanta, GA Full Time
    About Rialtic Rialtic is an enterprise software platform empowering health insurers and healthcare providers to run thei...

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