Job Description

Overview

The Payment Integrity Analyst I supports the accuracy, consistency, and timely resolution of payment-related activity. The role's primary assignment is monitoring High Return Rate reporting and managing related cases through research, documentation, direct client communication, remediation follow-up, appropriate escalation, and closure. The analyst uses approved return-rate reporting and the designated case-management tracker to convert flagged activity into timely, documented action. The analyst applies established procedures and sound judgment to recognize trends, discrepancies, recurring issues, and potential risks, taking timely action within the role's authority and escalating matters that require management review.

Cross-training across additional Payment Integrity processes is a secondary responsibility that supports operational coverage and continuity after proficiency in the primary assignment is established.

Responsibilities

Essential Responsibilities

• Monitor approved High Return Rate reporting and related payment activity to identify cases requiring review, follow-up, or timely intervention; maintain the corresponding case-management tracker.
• Manage assigned High Return Rate cases from intake through closure by researching activity, validating available information, documenting root cause, maintaining accurate status, completing required follow-up, and meeting established service expectations.
• Communicate directly with clients to request information, explain case status or required next steps, coordinate responses, document commitments, track remediation actions and due dates, and support timely resolution.
• Review returned payment activity for patterns, discrepancies, recurring behavior, and potential risk indicators; determine the appropriate next action using established guidelines and escalate exceptions or higher-risk matters to the Payment Integrity Manager.
• Prepare, review, and reconcile operational reports and case data to identify items requiring action or management attention; summarize open cases, aging, remediation progress, repeat issues, and emerging trends.
• Maintain complete, accurate, and timely case notes, supporting documentation, client communications, and disposition records in designated systems.
• Demonstrate initiative by acting on observable trends, unresolved items, and emerging issues without waiting for task-by-task direction, while seeking guidance when a decision falls outside established procedures or role authority.
• Support payment-related investigations by gathering facts, validating documentation, and clearly summarizing findings for management review.
• Follow established procedures and controls, identify gaps or inconsistencies encountered during daily work, and raise observations to the Payment Integrity Manager.
• Partner with internal teams to obtain information, coordinate case activity, and resolve routine operational dependencies.
• Cross-train on designated Payment Integrity processes and provide secondary coverage as assigned once proficiency in the primary High Return Rate responsibilities is demonstrated.
• Perform other related duties and operational support activities as assigned.

Qualifications

Skills and Competencies

• Intermediate Microsoft Excel skills required, including sorting and filtering, formulas, lookups, PivotTables, conditional formatting, and organizing data for analysis; advanced Excel skills preferred.
• Ability to analyze operational and payment data, recognize patterns or exceptions, and distinguish routine next steps from matters requiring escalation.
• Sound judgment and initiative, with the ability to act proactively within established procedures and defined authority.
• Clear, professional written and verbal communication skills, including comfort communicating directly with clients about cases, documentation needs, and next steps.
• Strong organization and case-management discipline, with the ability to manage multiple priorities, follow through on open items, and maintain accurate records.
• Attention to detail and the ability to work consistently in process- and control-oriented environments.
• Adaptability and the ability to learn multiple operational processes while maintaining proficiency in the primary assignment.
• Ability to collaborate effectively with internal partners and appropriately escalate concerns or decisions.

Experience

• 1-2 years of experience in payment operations, financial operations, banking operations, customer support, operations analysis, or a related analytical or operational role.
• Experience reviewing reports, researching transactions or account activity, managing cases or queues, and documenting outcomes.
• Experience communicating directly with external clients or customers in an operational or service environment preferred.
• Payments, returns, risk operations, or financial-services experience preferred.

Work Schedule

This position must work a schedule aligned with U.S. business hours, including availability during the core hours established by management to support client communication, case follow-up, and team coordination.

Role Scope

This is a professional individual-contributor role. The analyst independently executes approved monitoring and case-management procedures, applies judgment to routine and moderately complex situations, and escalates decisions involving elevated risk, policy interpretation, account restrictions, funding suspension, technical direction, or broader process ownership.