Alaffia Health Benefits Overview

Manage the end-to-end payment integrity audit lifecycle, including provider documentation requests, follow-ups, inbox triage, audit finding letters, case tracking, and communication logging. Maintain accurate, compliant workflows, improve SOPs, coordinate with clinical auditors, appeal teams, and product teams, and provide professional, empathetic provider support. Use Microsoft Office and Google Workspace tools, including spreadsheets, formulas, filters, and pivot tables, for tracking and reporting.

Owns end-to-end implementation delivery for healthcare payment integrity clients, including requirements gathering, platform configuration, claims data integration, validation, troubleshooting, project planning, risk management, stakeholder communication, and go-live handoff. Partners with Engineering, Product, and clinical teams while developing scalable implementation methodologies, templates, and best practices.

Leads and scales the account management function for enterprise health plan customers. Manages Account Managers, owns team revenue and retention targets, develops account processes and playbooks, and oversees strategic accounts. Builds executive relationships, leads QBRs, manages escalations, identifies expansion opportunities, and partners with Sales, Product, Engineering, and Leadership to improve customer outcomes, retention, and revenue growth.