Provider Relations Operations Associate

About Alaffia & Our Mission

Each year, the U.S. healthcare system suffers from over $500B in wasted spending due to medical billing fraud, waste, and administrative burden. At Alaffia, we’re on a mission to change that. We’ve assembled a team of clinicians, AI/ML engineers, and product experts to build advanced AI that finally bends the cost curve for all patients across our ecosystem. We’re a high-growth, venture-backed startup based in NYC and are actively scaling our company.

Our Culture

At Alaffia, we fundamentally believe that the whole is more valuable than the sum of its individual parts. Further to that point, we believe a diverse team of individuals with various backgrounds, ideologies, and types of training generates the most value. Our people are entrepreneurial by nature, problem solvers, and are passionate about what they do — both inside and outside of the office.

About the Role & What You’ll Be Doing

As a Payment Integrity Operations Associate , you’ll be at the center of our audit execution and provider communication processes.You will manage the end-to-end audit lifecycle — from document requests and follow-ups to final findings delivery — ensuring every step is timely, compliant, and professional.

This is a fast-paced, detail-driven role ideal for someone who loves operations, thrives in a structured environment, and takes pride in excellent communication and customer service. You’ll collaborate closely with clinical reviewers, audit managers, and product teams to ensure seamless provider experiences and efficient audit throughput.

Your Responsibilities

• Own the audit lifecycle: Track and manage cases from initial document request to final audit finding, ensuring deadlines are met and communication is timely.
• Send and follow up on documentation requests: Coordinate with providers to obtain required medical records, maintaining professionalism and persistence in all outreach. Additionally, accessing customer electronic systems to obtain records when needed.
• Manage the provider inbox: Monitor incoming provider communications, triage requests, and respond to inquiries within established turnaround times.
• Compose and send audit finding letters: Prepare and deliver audit determinations and outcome communications, ensuring clarity and accuracy in all correspondence.
• Optimize workflows: Identify process gaps and inefficiencies; create or update SOPs to drive greater consistency, accuracy, and throughput.
• Maintain organized documentation: Log all communications, updates, and task completions within internal systems to ensure full audit traceability.
• Collaborate cross-functionally: Work closely with clinical auditors, appeal teams, and product teams to resolve issues and ensure smooth handoffs.
• Deliver a high-touch provider experience: Represent Alaffia Health professionally in all interactions — balancing compliance with empathy and customer care.

What We're Looking For

• 4+ years of experience in healthcare operations, provider relations, or audit support (payment integrity, utilization review, claims, or revenue cycle experience preferred)
• Excellent written and verbal communication skills — able to write clear, professional correspondence to providers and clients.
• Highly organized and comfortable managing multiple concurrent workflows in a fast-paced environment.
• Strong sense of accountability and ownership; you take initiative and don’t let details slip.
• Exceptionally detail-oriented with a keen eye for accuracy and completeness in documentation, communication, and data entry.
• Familiarity with claims auditing, medical record procurement, or health plan operations is a plus.
• Proficient in Microsoft Office Suite (Excel, Word, Outlook) and Google Workspace (Docs, Sheets); comfortable using formulas, filters, and pivot tables for tracking and reporting.

What Else Do You Get Working With Us?

• Access to Medical, Dental, and Vision benefits
• Flexible, paid vacation policy
• Work in a flat organizational structure — direct access to Leadership