ZipRecruiter

Log In

1

Payment Integrity Auditor Jobs (NOW HIRING)

Corvel

Payment Integrity Supervisor

Fort Worth, TX · Remote

$77K - $120K/yr

The Payment Integrity Supervisor is responsible for the daily activities of payment integrity team ... CCS or CIC required with DRG auditing experience in ICD-10-CM, ICD-10-PCS * Proficiency in both MS ...

CERiS

Payment Integrity Supervisor

Fort Worth, TX · Remote

$77K - $120K/yr

The Payment Integrity Supervisor is responsible for the daily activities of payment integrity team ... CCS or CIC required with DRG auditing experience in ICD-10-CM, ICD-10-PCS * Proficiency in both MS ...

Corvel

Payment Integrity Supervisor

Fort Worth, TX · On-site

$77K - $120K/yr

The Payment Integrity Supervisor is responsible for the daily activities of payment integrity team ... CCS or CIC required with DRG auditing experience in ICD-10-CM, ICD-10-PCS * Proficiency in both MS ...

Centene

Manager, Payment Integrity- Readmission

$87K - $157K/yr

Manages a team of auditors and clinical professionals and is accountable for audit quality ... Lead and oversee Payment Integrity initiatives focused on potentially preventable readmissions ...

BerryDunn

Medicaid Payment Integrity SME

Kapolei, HI · On-site +1

Claims, eligibility, provider, member, TPL, payment integrity, and related Medicaid or vendor ... Experience reviewing or auditing Medicaid medical, dental, behavioral health, pharmacy, provider ...

BerryDunn

Medicaid Payment Integrity SME

Kapolei, HI · On-site

$110 - $140/hr

Claims, eligibility, provider, member, TPL, payment integrity, and related Medicaid or vendor ... Experience reviewing or auditing Medicaid medical, dental, behavioral health, pharmacy, provider ...

BerryDunn

Medicaid Payment Integrity SME

Claims, eligibility, provider, member, TPL, payment integrity, and related Medicaid or vendor ... Experience reviewing or auditing Medicaid medical, dental, behavioral health, pharmacy, provider ...

previous pagenext page

Showing results 21-40

All JobsFinance and Insurance JobsAccounting JobsAccounting Professional JobsPayment Integrity Auditor Jobs

Payment Integrity Auditor information

See salary details

$38.5K

$92.8K

$151K

How much do payment integrity auditor jobs pay per year?

As of Sep 5, 2026, the average yearly pay for payment integrity auditor in the United States is $92,797.00, according to ZipRecruiter salary data. Most workers in this role earn between $72,000.00 and $112,000.00 per year, depending on experience, location, and employer.

What is a payment integrity auditor?

Payment Integrity Auditors are professionals who review healthcare claims and financial transactions to ensure payments are accurate and compliant with regulations. They identify overpayments, underpayments, and fraudulent activities by analyzing billing data, medical records, and policy guidelines. Their work helps healthcare organizations minimize financial losses, improve operational efficiency, and maintain compliance with government and industry standards.

What are the key skills and qualifications needed to thrive as a payment integrity auditor?

To thrive as a Payment Integrity Auditor, you need strong analytical skills, attention to detail, and a solid understanding of healthcare claims, typically supported by a degree in finance, healthcare administration, or a related field. Familiarity with claims processing systems, data analysis tools like Excel or SQL, and knowledge of relevant regulations such as HIPAA are often required. Effective communication, investigative mindset, and problem-solving abilities are essential soft skills for identifying discrepancies and collaborating with cross-functional teams. These skills are crucial for ensuring accurate payments, detecting fraud, and maintaining compliance within healthcare organizations.

What are some common challenges payment integrity auditors face when reviewing healthcare claims?

Payment Integrity Auditors often encounter challenges such as identifying complex billing errors, staying current with frequently changing healthcare regulations, and navigating large volumes of claims data. They must also collaborate with various departments, like clinical teams and compliance, to verify the accuracy of claims and resolve discrepancies. Strong analytical skills and attention to detail are crucial for success in this dynamic and fast-paced environment.

What is the difference between Payment Integrity Auditor vs Claims Analyst?

AspectPayment Integrity AuditorClaims Analyst
Required CredentialsCertification in auditing or healthcare compliance often preferredRelevant degrees in healthcare, finance, or related fields; certifications vary
Work EnvironmentHealthcare organizations, insurance companies, government agenciesInsurance companies, healthcare providers, third-party administrators
Employer & Industry UsageFocuses on verifying payment accuracy and fraud detectionAnalyzes claims data to determine validity and processing issues

Payment Integrity Auditors primarily focus on verifying the accuracy of payments and detecting fraud, while Claims Analysts review and process claims data to ensure proper reimbursement. Both roles require knowledge of healthcare billing and compliance, but Payment Integrity Auditors emphasize auditing and fraud prevention, whereas Claims Analysts focus on claims processing and analysis.

More about Payment Integrity Auditor jobs

What cities are hiring for Payment Integrity Auditor jobs?

Cities with the most Payment Integrity Auditor job openings:

What states have the most Payment Integrity Auditor jobs?

States with the most job openings for Payment Integrity Auditor jobs include:

What job categories do people searching Payment Integrity Auditor jobs look for?

The top searched job categories for Payment Integrity Auditor jobs are:

Payment Integrity Auditor jobs near you
Infographic showing various Payment Integrity Auditor job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $92,797 per year, or $44.6 per hour.

Senior Payment Integrity Analyst

Inland Empire Health Plans

Rancho Cucamonga, CA • On-site

$105 - $135/hr

Other

Medical, Dental, Vision, Life, Retirement

Posted 12 days ago

Job description

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to anauthentic experience!


Reporting to the Manager, Payment Integrity Operations, the Senior Payment Integrity Analyst provides lead level analyst support to a team of Payment Integrity Analysts on daily operations of vendor(s) and internal programs for Payment Integrity. The incumbent provides quality assurance of junior analysts’ work and action on remediation plans to develop cost avoidance opportunities. This position leads the reporting and tracking of all vendor activity to provide daily and monthly reporting to management. The incumbent partners with leaders and functional representatives to drive health plan financial performance through evaluation and execution of operational initiatives tied to payment integrity (PI) and provider claims accuracy. The Senior Payment Integrity Analyst makes recommendations that inform decisions which contribute to health plan strategy, and acts as a trusted voice in assessing and assisting resolution of complex business challenges that impact cost-containment and regulatory compliance.


Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.


Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.



  • Competitive salary

  • State of the art fitness center on-site

  • Medical Insurance with Dental and Vision

  • Life, short-term, and long-term disability options

  • Career advancement opportunities and professional development

  • Wellness programs that promote a healthy work-life balance

  • Flexible Spending Account – Health Care/Childcare

  • CalPERS retirement

  • 457(b) option with a contribution match

  • Paid life insurance for employees

  • Pet care insurance


Education & Requirements

  • A minimum of five (5) years of experience in a combination of payment integrity, claims auditing, and/or medical coding required

  • Strong data analysis/queries experience

  • Experience with contract and Division of Financial Responsibility (DOFR) interpretation

  • Bachelor’s degree in business, health administration, or a related field from an accredited institution required

    • In lieu of the required degree, a minimum of four (4) years of additional relevant work experience is required for this position

    • This experience is in addition to the minimum years listed in the Experience Requirements above



  • Certification in RHIA, RHIT, CCS, CPC, CIC or similar certification preferred


Key Qualifications

  • Strong knowledge and deep understanding of:

    • Billing regulations (CMS, HIPAA), DRG, ICD-10, and CPT coding

    • Medical coding (CPT, ICD-10, HCPCS) and health insurance contracts

    • The full claims lifecycle, including share of cost and coordination of benefits

    • Medicaid/Medi-Cal or Medicare regulatory frameworks

    • Payment integrity concepts (pre-pay audit, post-pay audit types, DRG validation, coordination of benefits and comparable concepts)

    • Data file layouts and system configurations to troubleshoot and coordinate remediation efforts with IT and vendors


  • Strong analytical skills with the ability to analyze large datasets and identify patterns

  • Strong proficiency in SQL, data visualization tools, and MS Excel

  • Strong written and verbal communication skills, including ability to synthesize complex information

  • Proven ability to:

    • Analyze data to inform business decisions

    • Work independently and apply business judgment in a highly regulated, cross-functional environment



Start your journey towards a thriving future with IEHP and apply TODAY!


#J-18808-Ljbffr

Apply