Atlanta, Georgia, United States
Client Payment Integrity Policy Manager Overview As a Client Payment Integrity Policy Manager, you will serve as a trusted partner to our clients, helping them optimize and manage their claims editing portfolios to maximize identification of potential overpayments. This role sits at the intersection of client engagement, healthcare payment policy expertise, and strategic content management. You will not only respond to client needs but also guide them toward approaches that generate maximum long-term value, balancing immediate requests with what drives the greatest impact for their long-term business outcomes.
You will work closely with client management, product, engineering, and strategic content leadership—deeply embedded in both our client and internal teams. This is an opportunity to combine subject matter expertise with consultative influence, helping clients transform how they manage payment integrity policies while advancing the overall roadmap of our platform.
Responsibilities Client Partnership & Policy Expertise : Act as the primary subject matter expert and trusted advisor to clients on payment integrity policies and claims editing.
Creatively tailor and fine-tune policies to client-specific circumstances, ensuring maximum savings while minimizing provider abrasion.
Guide clients to balance short-term requests with long-term strategies that generate sustainable impact.
Present and explain policy rationale, value, and implications during client interactions.
Strategic Value & Insights : Prioritize and recommend policies based on savings potential, client needs, and strategic alignment.
Quantify and clearly communicate the value of policies using data-driven analysis.
Identify adoption gaps, inefficiencies, or emerging opportunities and work with clients to address them.
Cross-Functional Collaboration : Partner with Client Success to integrate into client workflows and decision-making.
Communicate client policy needs in a way that informs and shapes product requirements, influencing the roadmap where appropriate.
Collaborate with product, engineering, and content leadership to ensure client perspectives are reflected in platform evolution.
Execution & Delivery : Oversee policy implementation processes, ensuring accuracy, timeliness, and measurable results.
Develop clear, client-facing content materials, analyses, and reporting.
Track and report on client adoption trends, decisions, and outcomes.
Qualifications Required 5-7 years of work experience in payment integrity at a health plan, claims editing vendor, or similar environment.
Coding, billing, or auditing credentials (e.g., CPC, CCS, or equivalent specialty certifications). A certification in coding is mandatory for this position.
Expertise in interpreting medical policies, applying correct coding guidelines, and understanding the top claims error reasons.
Demonstrated experience advising clients and explaining complex medical policy / payment accuracy concepts.
Strong analytical skills with the ability to quantify and communicate policy value.
Proven experience managing claims editing implementations or similar client delivery initiatives.
Preferred : Expertise across both professional and institutional claims.
Advanced skills with Google Suite or similar tools.
Experience working cross-functionally with product and engineering teams.
Excellent written and verbal communication skills with strong influencing ability.
Rialtic is an equal-opportunity employer. We value diversity and encourage candidates of all backgrounds to apply.
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
Open PTO plan 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 and are remote-friendly.
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 are 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.
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Inc Is Hiring Content • Atlanta, GA, United States