ZipRecruiter

Log In

1

Healthcare Payment Integrity Analyst Jobs (NOW HIRING)

HealthOne Alliance

Payment Integrity Analyst

Dalton, GA · On-site

Our PURPOSE is to care for people by connecting them to resources that help protect them in health ... JOB PURPOSE A Payment Integrity Analyst reviews healthcare claims, payments, and billing to find ...

Corvel

Payment Integrity Analyst II

Fort Worth, TX · Remote

$66K - $101K/yr

The Payment Integrity Analyst is responsible for accurately reviewing pre and post pay claim audits ... Strong understanding of healthcare revenue cycle and claims reimbursement * Proficient in Microsoft ...

CERiS

Payment Integrity Analyst II

Fort Worth, TX · Remote

$66K - $101K/yr

The Payment Integrity Analyst is responsible for accurately reviewing pre and post pay claim audits ... Strong understanding of healthcare revenue cycle and claims reimbursement * Proficient in Microsoft ...

Corvel

Payment Integrity Analyst II

Fort Worth, TX · On-site

$66K - $101K/yr

The Payment Integrity Analyst is responsible for accurately reviewing pre and post pay claim audits ... Strong understanding of healthcare revenue cycle and claims reimbursement * Proficient in Microsoft ...

View Moreicons

$150 - $200/hr

Explore meaningful roles that let you make an impact in healthcare while growing your career with ... Director Payment Integrity Analytics Sagility combines industry-leading technology and ...

Avera Health

Revenue Integrity Analyst

Sioux Falls, SD · On-site

$25.50 - $38.25/hr

Two to three years experience in healthcare revenue cycle analytics, charge auditing, or payment integrity. * Knowledge of healthcare billing, denial management, and/or payer reimbursement ...

BerryDunn

Claims Data Analyst

Kapolei, HI · On-site

Experience analyzing healthcare, Medicaid, claims, billing, audit, compliance, payment integrity, or government program data. * Strong data analysis, reporting, dashboarding, SQL, statistical ...

Socket.dev

Claims Data Analyst

Kapolei, HI · On-site

$100 - $125/hr

Experience analyzing healthcare, Medicaid, claims, billing, audit, compliance, payment integrity, or government program data. * Strong data analysis, reporting, dashboarding, SQL, statistical ...

next page

Showing results 1-20

All JobsHealthcare JobsHospital JobsMedical Biller JobsHealthcare Payment Integrity Analyst Jobs

Healthcare Payment Integrity Analyst information

See salary details

$35K

$75.6K

$132K

How much do healthcare payment integrity analyst jobs pay per year?

As of Sep 9, 2026, the average yearly pay for healthcare payment integrity analyst in the United States is $75,606.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,000.00 and $91,500.00 per year, depending on experience, location, and employer.

What does a healthcare payment integrity analyst do?

A Healthcare Payment Integrity Analyst is responsible for reviewing healthcare claims and payments to ensure accuracy, prevent fraud, and identify overpayments or underpayments. They analyze data, audit claims, and collaborate with healthcare providers and insurers to resolve discrepancies. Their work helps to control costs, improve the efficiency of payment processes, and ensure compliance with regulations. These analysts often use specialized software and strong analytical skills to detect patterns and recommend improvements.

What are the key skills and qualifications needed to thrive as a healthcare payment integrity analyst, and why are they important?

A Healthcare Payment Integrity Analyst needs strong analytical abilities, knowledge of healthcare claims processes, and a relevant degree such as in health administration or finance. Familiarity with claims adjudication software, data analysis tools like Excel or SQL, and sometimes certifications in coding (such as CPC) are typical requirements. Attention to detail, problem-solving skills, and effective communication help analysts identify discrepancies and collaborate with cross-functional teams. These competencies are essential for ensuring accurate payments, reducing fraud, and maintaining financial integrity within healthcare organizations.

What are some common challenges faced by healthcare payment integrity analysts, and how can they be effectively managed?

Healthcare Payment Integrity Analysts often encounter challenges such as identifying complex billing discrepancies, staying updated on ever-changing healthcare regulations, and managing large volumes of claims data. To effectively manage these challenges, analysts typically leverage advanced data analytics tools, participate in ongoing training on regulatory changes, and collaborate closely with cross-functional teams such as compliance, finance, and clinical staff. Strong attention to detail and proactive communication are key to ensuring accuracy and efficiency in safeguarding against improper payments.

What are popular job titles related to Healthcare Payment Integrity Analyst jobs?

For Healthcare Payment Integrity Analyst jobs, the most frequently searched job titles are:

Infographic showing various Healthcare Payment Integrity Analyst job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 67% Full Time, 14% Part Time, and 17% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $75,606 per year, or $36.3 per hour.

Payment Integrity Analyst

Dalton, GA • On-site

Health One Alliance, LLC
Insurance Services • 11 - 50 employees
Learn more about Health One Alliance, LLCexternal

$60 - $80/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago

Job description

JOB PURPOSE

A Payment Integrity Analyst reviews healthcare claims, payments, and billing to find errors, fraud, waste, or abuse, ensuring compliance with rules (like CMS) and policies, using strong data analysis, medical coding (CPT/ICD-10), and auditing skills to prevent financial loss and improve accuracy, often working with vendors and internal teams. Key duties include auditing claims, investigating anomalies, analyzing data for trends, collaborating on billing edits, and preparing reports to support cost containment for health plans.

ESSENTIAL JOB DUTIES
  • Review and audit healthcare claims to identify payment errors, overpayments, underpayments, fraud, waste, and abuse (FWA).
  • Ensure compliance with CMS regulations, state and federal guidelines, health plan policies, and provider contract terms.
  • Analyze medical records, itemized bills, and claim data to validate coding accuracy and medical necessity.
  • Apply CPT, HCPCS, ICD-10-CM/PCS, and modifier guidelines to validate correct reimbursement.
  • Identify trends, patterns, and anomalies through data analysis to support cost containment initiatives.
  • Perform detailed reviews of high-dollar and complex claims to ensure payment accuracy, contract compliance, and medical necessity prior to or after payment.
  • Investigate potential payment integrity issues, including duplicate payments, unbundling, upcoding, and incorrect modifiers.
  • Collaborate with internal teams (Claims, Configuration, Provider Relations, Compliance, Legal, Analytics, Medical Management) to resolve findings.
  • Work closely with internal and external vendors to review audit findings, validate recoveries, and implement corrective actions.
  • Prepare detailed audit documentation, summaries, and reports for leadership, compliance, and recovery tracking.
  • Present audit findings and recommendations to stakeholders in a clear and professional manner.
  • Monitor and track audit outcomes, recoveries, and key performance indicators (KPIs).
  • Participate in continuous process improvement initiatives to enhance payment accuracy and efficiency.
  • Stay current with regulatory updates, coding changes, CMS guidance, and industry best practices.
  • Support internal and external audits, regulatory requests, and compliance reviews as needed.
  • Maintain regular and predictable attendance.
  • Consistently demonstrate compliance with HIPAA regulations, professional conduct, and ethical practice.
  • Work to encourage and promote company culture throughout the organization.
  • Other duties as may be assigned.
QUALIFICATIONS
  • High School Diploma or GED required.
  • Associates or Bachelor's degree preferred.
  • A minimum of three years’ experience in claims processing required, must include Professional and Institutional processing; previous experience in medical billing and coding required if no claims processing experience.
  • Knowledge of ICD-10, CPT4, DRG, HCPCS codes, medical terminology, EDI and HIPAA protocols preferred.
  • Knowledge of UB and HCFA 1500 forms.
  • Experience with Word and Excel.
  • Experience with SQL reporting is preferred.
PHYSICAL REQUIREMENTS

Prolonged periods of sitting at a desk and working on a computer. Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities. Must be able to drive a vehicle and daytime/overnight travel as required.

BENEFITS
  • 401K (4% Match, Immediate Vesting)
  • Accident insurance
  • Competitive salary
  • Critical Illness Insurance
  • Dental Insurance
  • Employee Assistance Program
  • Flexible Spending Account
  • Health & Wellness Program
  • Health Savings Account
  • Life & AD&D Insurance
  • Long Term Disability
  • Medical Insurance
  • Paid Time Off
  • Pet Insurance
  • Short Term Disability
  • Vision Insurance
EQUAL OPPORTUNITY EMPLOYER

HealthOne is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status, or any other status protected by state or federal law.

#J-18808-Ljbffr

Apply