Payment Integrity Intern

Public Partnerships | PPLUS TX Remote, TX
$19 - $22Remote

About The Position

Public Partnerships LLC supports individuals with disabilities or chronic illnesses and aging adults, to remain in their homes and communities and “self” direct their own long-term home care. Our role as the nation’s largest and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and services within their state-approved personalized budget. We are appointed by states and managed healthcare organizations to better serve more of their residents and members requiring long-term care and ensure the efficient use of taxpayer funded services. Our culture attracts and rewards people who are results-oriented and strive to exceed customer expectations. We desire motivated candidates who are excited to join our fast-paced, entrepreneurial environment, and who want to make a difference in helping transform the lives of the consumers we serve. (learn more at www.pplfirst.com). The Authorization, Eligibility & Payment Integrity Analyst will support operational functions across authorization management, eligibility review, enrollment processing, timesheet pend management, CRM administration, reporting, and cross-functional process improvement initiatives.The position provides exposure to PPL’s operational lifecycle and collaboration across multiple functional areas.

Requirements

  • Motivated and eager to learn, with an interest in healthcare operations and improving processes.
  • Strong problem-solving and critical thinking skills, with the ability to analyze information and identify patterns.
  • Detail-oriented with a focus on accuracy and quality in work.
  • Good organizational and time management skills, with the ability to handle multiple tasks and meet deadlines.
  • Clear verbal and written communication skills, with the ability to work professionally with team members and others.
  • Customer-service oriented, with a helpful and responsive approach.
  • Basic to intermediate Microsoft Excel skills preferred (e.g., sorting, filtering, simple formulas; exposure to pivot tables or lookups is a plus).
  • Proficiency in Microsoft Office tools such as Excel, Word, Outlook, and PowerPoint.
  • Familiarity with CRM systems or data/reporting tools is a plus but not required.
  • Willingness and ability to quickly learn new systems, processes, and program rules.
  • Ability to work independently while also contributing as part of a team.
  • Demonstrates professionalism, accountability, and good judgment.

Nice To Haves

  • Prior internship, coursework, or project experience involving data analysis, customer service, operations, or administrative functions is a plus.

Responsibilities

  • Support day-to-day Authorization, Eligibility, Enrollment, and Payment Integrity operations across the PPL portfolio.
  • Obtain approved authorizations for services to be paid in accordance with payer requirements and State program rules.
  • Ensure authorizations, eligibility files, and enrollment records are processed and maintained in alignment with company policies, client requirements, and program protocols.
  • Build working knowledge of PPL operating systems, program rules, payer requirements, and operational processes.
  • Assist in identifying, researching, and resolving pending timesheet, authorization, eligibility, and enrollment issues in accordance with operational procedures and program requirements.
  • Create, document, track, and manage CRM cases to support operational workflows, issue resolution, and administrative functions.
  • Respond to inquiries through CRM, system tools, and email in a professional, timely, and service-oriented manner.
  • Assist with the maintenance, integrity, and accuracy of authorization records and supporting operational documentation.
  • Maintain and update reporting tools, operational trackers, and audit documentation to support compliance and operational oversight.
  • Maintain records in accordance with audit, compliance, and internal control requirements.
  • Utilize analytical and data research skills to identify trends, investigate issues, and support operational process improvements.
  • Assist in preparing written reports, process documentation, operational summaries, and internal presentations.
  • Participate in internal and external meetings related to Authorization, Eligibility, Enrollment, and Payment Integrity operations.
  • Collaborate with cross-functional teams to support operational initiatives, issue resolution, and workflow improvements.
  • Route mail, email, and administrative tasks as assigned to support efficient department operations.
  • Support assigned operational projects and deliverables as directed by leadership.

Benefits

  • Compensation range: $19.24-$22.00/hourly
  • Actual compensation will be determined based on a variety of factors, including skills, experience, and geographic location.
  • Compensation may vary for positions based in high cost-of-labor markets.
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