Client Service Analyst - Payment Integrity Operations (FWA)

Client Service Analyst - Payment Integrity Operations (FWA) Job Locations US-UT-South Jordan ID 2026-20430 Category Fraud, Waste, and Abuse Position Type Full-Time Overview The Client Service Analyst (CSA) ensures adequate support for the client-facing team on coding and policy as well as operational related activities. The CSA must be familiar with the day-to-day activities of the Client Policy Manager (CPM), Client Service Manager (CSM) and client-facing Medical Directors. The CSA also oversees the intake and development of client policy and claim-editing rules, partnering with the Content and Research and Development (RandD) teams to ensure rules are configured accurately and meet client requirements. Responsibilities Assist with internal projects, take lead on larger client projects as needed with the ability to drive multiple projects/tasks, prioritize, and meet deadlines. * Ability to effectively present information, respond to questions from peers, gather topics and schedule client and internal stakeholder meetings. * Ensures technical documents and other deliverables such as rule intake forms, process guides, job aids, and operating instructions remain current. * Provides support to new CSAs by shadowing and assisting in role-based training. * Participates in software UAT as a Client Delivery representative. * Oversees the intake and development of new and updated policy and claim-editing rules, coordinating with the Content and Research and Development (RandD) teams throughout the rule lifecycle to ensure rules are configured to meet client needs: * Performs intake of new and revised client rule requests, confirming requirements, effective dates, and supporting documentation before routing for development. * Partners with Content and RandD teams to translate client policy intent into configured rules, asking clarifying and follow-up questions to confirm intended outcomes. * Reviews new rule requests against the existing rule library to identify overlapping or substantially similar rules already in production, escalating conflicts for resolution. * Researches claims data and report output to validate rule logic, confirm expected rule behavior, and support decisions during rule design and testing. * Investigates and resolves situations where a proposed rule conflicts with existing client customizations or configuration. * Tracks rule requests through intake, development, testing, and production release, documenting status and decisions in the appropriate tracking application. * Generates presentations for client and internal ad hoc change requests. For ad hoc requests the CSA documents and finalizes decisions in the appropriate application and creates the Project Request, attaching all documents and assigning to appropriate Operations Team member(s). * Runs reports to identify and close Project Requests as defined by CPM/CSM after the production release lockdown each month. * Reviews, analyzes, and responds to Policy and Operational Inquiries by defined desired completion date. Communicates to the client team when the desired completion date needs to be adjusted due to complexity and/or additional research. * Performs multi-faceted data and report analytics. Determines the applicable reports to run based on the client team inquiry. Analyzes the report output and provides accurate client or policy information based on thorough report analytics. * Generates, modifies, and formats reports for ad hoc purposes which includes determining the nece ssary parameters and building the report, performing analysis and summarizes findings to the client team. * Enters client inquiries, report requests, and research requests into the designed software application (i.e.,... For full info follow application link. Equal Opportunity Employ r/Protected Veterans/Individuals with Disabilities