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How much do payment integrity analyst jobs pay per hour?

As of Jul 1, 2026, the average hourly pay for payment integrity analyst in the United States is $31.53, according to ZipRecruiter salary data. Most workers in this role earn between $25.24 and $35.82 per hour, depending on experience, location, and employer.

What healthcare jobs pay over $100k per year?

For a Payment Integrity Analyst, salaries over $100,000 annually are common in senior or specialized roles, especially with experience, certifications, and advanced skills in data analysis, healthcare reimbursement, or auditing. Other high-paying healthcare jobs include healthcare executives, physicians, and certain IT roles like health informatics managers. Salary levels vary based on location, experience, and employer size.

What are the typical responsibilities of a Payment Integrity Analyst on a daily basis?

A Payment Integrity Analyst typically reviews healthcare claims for accuracy, audits processed payments to detect errors or potential fraud, and analyzes data to identify trends or recurring issues. You’ll collaborate closely with claims adjusters, medical coders, and compliance teams to resolve discrepancies and implement improvements. The role often involves preparing reports, documenting findings, and recommending solutions to streamline payment processes. This job requires strong analytical skills and effective communication as you’ll bridge the gap between raw data and actionable business decisions.

What are the key skills and qualifications needed to thrive in the Payment Integrity Analyst position, and why are they important?

To thrive as a Payment Integrity Analyst, you need strong analytical skills, attention to detail, and a background in healthcare billing, finance, or related fields. Experience with data analysis tools (such as Excel, SQL, or Tableau), healthcare claims systems, and knowledge of industry regulations or certifications like CPC or CPMA are highly valued. Strong problem-solving abilities, effective communication, and collaboration skills help analysts navigate complex data and work efficiently with cross-functional teams. These competencies are vital for accurately identifying discrepancies, optimizing payment processes, and ensuring financial accuracy within healthcare organizations.

What does a Payment Integrity Analyst do?

A Payment Integrity Analyst is responsible for reviewing healthcare claims, payments, and billing practices to identify errors, fraud, waste, or abusive billing patterns. They analyze data, conduct audits, and work with providers and internal teams to ensure compliance with healthcare regulations and payer policies. Their role helps prevent financial losses and improves the accuracy of payments in the healthcare industry.

How much does a payment integrity analyst make?

A payment integrity analyst typically earns between $50,000 and $80,000 annually, depending on experience, location, and certifications. Entry-level roles may start lower, while experienced analysts with specialized skills can earn higher salaries. The role often requires knowledge of healthcare billing, data analysis tools, and compliance standards.

What does a payments analyst do?

A payments analyst reviews and processes financial transactions to ensure accuracy and compliance with company policies and industry regulations. They analyze payment data, identify discrepancies or fraud, and collaborate with teams to resolve issues, often using tools like Excel or payment processing software. Strong attention to detail and knowledge of financial systems are essential for this role.

What does a payment integrity analyst do?

A payment integrity analyst reviews healthcare claims and payment data to identify and prevent errors, fraud, and overpayments. They analyze claims using data analysis tools, ensure compliance with regulations, and recommend process improvements to reduce financial losses for organizations. Strong attention to detail and knowledge of billing systems are essential for this role.
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Payment Integrity Analyst jobs near you
Infographic showing various Payment Integrity Analyst job openings in the United States as of June 2026, with employment types broken down into 97% Full Time, 1% Part Time, and 2% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $65,589 per year, or $31.5 per hour.
Senior Analyst - Payment Integrity Analytics

Senior Analyst - Payment Integrity Analytics

Gainwell Technologies LLC

Dallas, TX • On-site

$69K - $99K/yr

Other

Medical, Life, Retirement, PTO

Posted 4 days ago

Gainwell Technologies rating

7.7

Company rating: 7.7 out of 10

Based on 72 frontline employees who took The Breakroom Quiz

115th of 202 rated software companies

Job description

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You'll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.
Summary
The Payment Integrity Analytics, Senior Analyst plays a critical, client-facing role supporting state Medicaid agencies by applying existing fraud, waste, and abuse (FWA) analytic models to Medicaid claims data and delivering monthly, prequalified FWA lead referrals. This role emphasizes producing clear, defensible, and actionable intelligence that can be readily understood and operationalized by state Office of Inspector General (OIG) staff and other program integrity stakeholders.
The analyst serves as a trusted analytical partner to the state, presenting and explaining FWA leads, responding to follow-up questions, and supporting investigations through data analysis, documentation, and, when required, testimony and travel related to fraud investigations. The role also includes translating state feedback, investigative outcomes, and audit results into recommendations for analytic improvements, program integrity controls, and broader Medicaid policy or operational changes.
Your role in our mission
  • Apply established FWA analytic models to Medicaid claims data to identify potential fraud, waste, and abuse.
  • Deliver monthly, prequalified FWA lead referral reports on a consistent and reliable cadence.
  • Produce reports that clearly articulate the analytic rationale, suspected behavior, and investigative relevance of each lead.
  • Ensure all outputs are defensible, audit-ready, and written for non-technical investigative and policy audiences.
  • Present FWA lead referrals to state Medicaid program integrity and OIG staff.
  • Explain findings, methodologies, and data sources in support of state investigations.
  • Respond to follow-up questions and perform supplemental or ad hoc analyses related to specific referrals.
  • Support investigations through documentation, exhibits, and data interpretation.
  • Participate in meetings, briefings, and, as needed, provide testimony or in-person investigative support (travel may be required).
  • Provide structured feedback to analytics and data science teams on model performance and data quality.
  • Recommend enhancements, modifications, or corrections to existing analytic models.
  • Translate state feedback and investigative outcomes into prioritized analytics roadmap items.
  • Analyze outcomes of other audit programs to identify systemic program integrity vulnerabilities.
  • Develop data-driven recommendations related to claims adjudication processes, controls, or edits.
  • Advise states on potential policy, regulatory, or statutory changes to reduce FWA risk and close program gaps.

What we are looking for
  • Extensive experience analyzing Medicaid claims and encounter data to identify fraud, waste, and abuse. (5+ years)
  • Deep knowledge of Medicaid program integrity, including common FWA schemes, audit methodologies, and investigative workflows. (5+ years)
  • Prepare reports and presentations documenting analytic methods and results for internal and external customers (4+ years)
  • Experience reading, interpreting, and applying Medicaid policy, regulations, state plan language, and related guidance.
  • Strong written and verbal communication skills, with experience presenting analytic findings to state agencies, Offices of Inspector General, or other oversight bodies.

Preferreed qualifications
  • Prior experience working directly with state Medicaid agencies and/or Offices of Inspector General is strongly preferred.
  • Professional certifications such as Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), and/or Accredited Health Care Fraud Investigator (AHFI) are preferred.

What you should expect in this role
  • Regular interaction with state Medicaid and OIG stakeholders
  • Fully remote opportunity with the option to work anywhere within the United States
  • Monthly delivery cadence tied to investigative operations
  • Balance of independent analytical work and client-facing collaboration
  • Occasional travel and participation in investigative or hearing-related activities (Up to 25%)
  • Video cameras must be used during all interviews, as well as during the initial week of orientation
  • The Deadline to submit applications for this posting is July 14, 2026.

The pay range for this position is $69,400.00 - $99,200.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

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About Gainwell Technologies

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With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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