Claim Payment Integrity

The School Board of Hillsborough County is seeking quotes for claim payment integrity services, effective January 1, 2026. The total number of eligible employees is approximately 24,328, with 78.5% currently enrolled in Medical/Rx coverage. The scope of work includes providing claim payment integrity services to ensure accurate and efficient processing of medical and prescription claims. Key aspects of the job include: • Claim payment processing and integrity services • Medical and prescription claims management • Compliance with relevant regulations and laws • Data analysis and reporting to ensure accurate claim payment The ideal candidate will have experience in claim payment integrity services, strong analytical skills, and the ability to work with large datasets. They will also need to demonstrate knowledge of relevant laws and regulations, such as HIPAA, and have excellent communication skills to work with stakeholders.