Senior Payment Accuracy Advisor

TBC Corporation

About The Position

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. The Senior Payment Accuracy Advisor (PAA) plays a key role in implementing and maintaining ClaimsXten (CXT) rules and rule logic to support client payment accuracy initiatives. This role involves partnering with assigned customers as part of a Service Delivery Team to understand claim systems, payment policies, and data integrations that impact total payment accuracy. The Senior PAA consults with clients to define requirements, resolve rule and non-rule issues, and ensure high-quality, on-time project delivery. As a trusted advisor, the Senior PAA collaborates across teams to deliver measurable results that align with client business objectives and Lyric’s standards of excellence. As a key member of the Customer Success function, this role consults with customers to deeply understand their business needs, documents requirements with precision, shapes and informs methodologies, leads course corrections when needed, and consistently demonstrates reliability and expertise. Through proactive engagement, continuous improvement, and sophisticated communication, the role ensures that both the organization and its customers achieve lasting success.

Requirements

Bachelor’s degree in computer science, healthcare, or a related field—or equivalent business experience
Minimum of four (4) years of combined healthcare, payor, or consulting experience
Minimum of two (2) years of medical claims experience within a payor environment
Familiarity with SDLC frameworks and project implementation lifecycles
Advanced skills in Microsoft Office Suite (Word, Excel, PowerPoint, Visio)
Experience with Jira, Confluence, and other project management tools
Strong understanding of integrations, data mapping, and claims processing systems
Ability to travel 10–15%

Nice To Haves

In-depth knowledge of payor environments and claims management operations
Understanding of diverse customer segments (national, strategic, and specialized)
Ability to identify client challenges and deliver effective, data-driven recommendations
Strong project coordination and milestone management skills
Active listening and analytical thinking for requirements gathering and solution design
Strong sense of ownership and accountability to ensure every client request, insight, and deliverable is acted upon, validated, and resolved to completion
Strong working knowledge of medical, clinical, coding, and healthcare terminology; and coding systems
Ability to articulate the clinical and business value of ClaimsXten and ClaimsXten rules and related Lyric products
Stay abreast of industry trends, regulatory changes, and emerging technologies.
Share thought leadership and actionable insights with customers to help them navigate market shifts and optimize their operations.
Exceptional written, verbal, and presentation skills
Confidently facilitate client meetings, presentations, and trainings
Organize regular touchpoints, executive briefings, and feedback loops to ensure ongoing alignment and satisfaction
Ability to communicate technical and business concepts clearly to diverse audiences
Possess ability to build strong, consultative relationships with customer stakeholders at all levels, adapting communication style and approach to suit diverse audiences.
Facilitate regular touchpoints, executive briefings, and feedback loops to ensure ongoing alignment and satisfaction.
Commitment to intentional and transparent communication across teams, confirming that internal understanding is aligned before external communication occurs.
Strong analytical and problem-solving skills; capable of working with complex data structures.
Ability to apply structured analysis and documentation practices to confirm data integrity and transparency in all technical outputs.

Responsibilities

Serve as the primary customer-facing resource for ClaimsXten rule development and production support.
Act as a consultative partner to customers, proactively engaging to understand their evolving needs, business drivers, and strategic objectives.
Facilitate discovery sessions and workshops to elicit, clarify, and document customer requirements, ensuring alignment with both immediate and long-term goals.
Regularly review and refine methodologies and processes based on customer feedback and industry best practices.
Demonstrate strong critical thinking by analyzing each customer’s business functions, understanding their lines of business, and evaluating the rationale behind rule exclusions and inclusions.
Tailor recommendations and solutions to the unique operational context of each client.
Approach every implementation step with structured execution and verification, confirming that all requirements and results are fully validated and communicated before completion.
Collaborate with clients to document business intent, technical requirements, and expected rule behavior.
Troubleshoot and resolve rule-related issues throughout implementation, upgrade, and post–Go Live phases.
Participate in testing, quality assurance, and defect remediation processes.
Utilize Jira, Salesforce, CRB, and other tools to manage development activities and maintain compliance with methodology standards.
Ensure all project milestones are achieved to support accurate customer invoicing.
Participate actively in Service Delivery Team (SDT) meetings, initiatives, and metrics tracking.
Serve as a visible and reliable advocate for Customer Success, ensuring that every interaction and deliverable reinforces trust, transparency, and partnership.
Anticipate potential challenges in customer operations and collaborate with the Service Delivery Team to develop strategies and contingency plans.
Actively participate in solution design to address emerging issues before they impact service delivery.
Serve as a subject matter expert (SME) for special projects and initiatives, leveraging exposure and acclimation with assigned customers to provide targeted insights and solutions.
Contribute to a collaborative team culture that emphasizes accountability, quality, and customer satisfaction.
Promote clarity and accountability by tracking commitments, confirming alignment among team members, and ensuring consistent, transparent delivery of outcomes.
Proactively identify opportunities to add value, anticipate challenges, and position the organization as a strategic ally in the customer’s success.
Partner with Engagement Managers and Staff PAAs to plan, forecast, and execute client projects.
Monitor project and service delivery outcomes, identifying when course corrections are needed to better meet customer expectations or adapt to changing business environments.
Lead change management efforts, communicating rationale and benefits of adjustments to both internal teams and customers.
Act as a direct and reliable partner to QA, BA, SIOps, and Engagement Managers, with a particular focus on ensuring that requirements are thoroughly understood, documented, and validated.
Strive to prevent unnecessary challenges by promoting comprehensive and accurate requirements gathering.
Maintain current knowledge of industry trends, regulatory changes, and best practices in claims adjudication.
Regularly assess how emerging developments may impact customers’ business and ClaimsXten rule logic, sharing insights with the team and clients.
Demonstrate excellence in documenting customer requirements, business processes, and solution designs.
Ensure all documentation is clear, comprehensive, and accessible for both internal and customer stakeholders.
Maintain living documentation that evolves with customer needs and project changes, supporting knowledge transfer and continuity.
Ensure seamless 100% PTO coverage by proactively documenting customer-specific processes, rules, and project status.
Collaborate with designated backup resources to bring them up to speed, enabling uninterrupted support for customer needs during scheduled absences.
Support internal projects aimed at improving tools, methodologies, and delivery processes.
Identify and lead initiatives for enhancing rule quality, automation, or operational efficiency.
Drive improvement initiatives with measurable outcomes, ensuring that each enhancement is implemented, validated, and communicated to stakeholders.
Leverage customer insights to shape and inform existing methodologies, recommending enhancements that drive greater value and efficiency.
Champion a culture of continuous improvement by soliciting and leveraging customer insights and outcomes to shape and inform existing methodologies, and to recommend enhancements that drive greater value and efficiency.
Provide input for project forecasts and resource planning.
Track and report on utilization, productivity, and other key performance metrics.
Execute forecasting and reporting activities with accuracy, visibility, and timely communication to maintain transparency and confidence in outcomes.
Participate in milestone planning with Engagement Managers to ensure timely client delivery.