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Payment Integrity Healthcare Jobs (NOW HIRING)

Bcbsa

Director, Payment Integrity

Chicago, IL · On-site

Preferred MS or MBA in Healthcare Administration, Public Health or Business Analytics Experience * Required 12+ Years Progressive Experience in healthcare payment integrity and claims operations ...

HealthEdge

Payment Integrity Strategy & Execution * Own the end-to-end payment integrity business strategy ... Drive innovation strategies leveraging AI, analytics, automation, and emerging healthcare ...

HealthEdge

VP, Payment Integrity

Payment Integrity Strategy & Execution * Own the end-to-end payment integrity business strategy ... Drive innovation strategies leveraging AI, analytics, automation, and emerging healthcare ...

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Payment Integrity Healthcare information

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How much do payment integrity healthcare jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for payment integrity healthcare in the United States is $19.91, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $20.91 per hour, depending on experience, location, and employer.

What jobs pay 4000 a week without a degree?

In healthcare, roles such as medical billing and coding specialists or healthcare consultants can sometimes reach $4,000 weekly with experience and certifications. These jobs often require strong knowledge of healthcare systems, attention to detail, and proficiency with relevant software but do not always require a college degree.

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

AspectPayment Integrity HealthcareClaims Analyst
Required CredentialsCertifications in healthcare compliance, coding, or auditingKnowledge of insurance policies, coding, and data analysis
Work EnvironmentHealthcare organizations, insurance companies, government agenciesInsurance companies, healthcare providers, third-party administrators
Employer & Industry UsageFocuses on detecting and preventing improper paymentsFocuses on reviewing and processing insurance claims

Payment Integrity Healthcare professionals primarily focus on identifying and preventing improper payments within healthcare billing, often requiring certifications in compliance or auditing. Claims Analysts review and process insurance claims, ensuring accuracy and adherence to policies. While both roles work within the healthcare and insurance industries, Payment Integrity Healthcare emphasizes fraud detection and payment accuracy, whereas Claims Analysts concentrate on claims processing and data analysis.

What does a payment integrity specialist do?

A payment integrity specialist reviews healthcare claims to identify and prevent improper payments, ensuring billing accuracy and compliance with regulations. They analyze data, investigate discrepancies, and work with healthcare providers and payers to resolve issues, often using claims processing systems and data analysis tools.

How much does a payment integrity analyst make?

A payment integrity analyst typically earns between $50,000 and $75,000 annually, depending on experience, location, and certifications. Entry-level roles may start lower, while experienced analysts with specialized skills can earn higher salaries, often with opportunities for bonuses and career advancement.

What is payment integrity in healthcare?

Payment integrity in healthcare involves ensuring that healthcare claims are accurate, valid, and compliant with regulations to prevent improper payments. Professionals in this field analyze claims, identify errors or fraud, and implement processes to improve billing accuracy and reduce financial losses for payers and providers.

What are some common challenges faced by professionals in Payment Integrity Healthcare roles, and how can they be addressed?

Professionals in Payment Integrity Healthcare often encounter challenges such as navigating complex healthcare regulations, managing large volumes of claims data, and ensuring accuracy in identifying overpayments or fraud. Staying updated on regulatory changes and leveraging advanced data analytics tools can help address these challenges. Additionally, collaboration with clinical, compliance, and IT teams is essential for thorough investigations and process improvements. Continuous training and staying informed about industry best practices are key to overcoming these hurdles.

What are the key skills and qualifications needed to thrive as a Payment Integrity Healthcare professional, and why are they important?

To thrive as a Payment Integrity Healthcare professional, you need expertise in healthcare claims analysis, knowledge of billing and coding standards, and often a degree in healthcare administration or a related field. Familiarity with claims management software, data analytics tools, and certifications such as CPC (Certified Professional Coder) or CPMA (Certified Professional Medical Auditor) are highly valued. Strong analytical thinking, attention to detail, and effective communication skills help professionals identify discrepancies and work collaboratively to resolve them. These skills are essential for preventing fraud, minimizing financial losses, and ensuring accurate healthcare reimbursements.
More about Payment Integrity Healthcare jobs
What cities are hiring for Payment Integrity Healthcare jobs? Cities with the most Payment Integrity Healthcare job openings:
What states have the most Payment Integrity Healthcare jobs? States with the most job openings for Payment Integrity Healthcare jobs include:
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Payment Integrity Healthcare jobs near you
Director, Healthcare - Payment Integrity

Director, Healthcare - Payment Integrity

West Monroe

Chicago, IL • On-site

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 16 days ago

Job description

Are you ready to make an impact?
Healthcare Payment Integrity Director
West Monroe has an immediate opportunity for a Director aligned to the Healthcare Practice. This role will focus on delivering business and technology consulting solutions for payer organizations, with a specialization in Payment Integrity, claims operations, reimbursement methodologies, and healthcare finance transformation.
Working alongside leaders across our National Healthcare Practice, this role will be responsible for developing and growing client relationships, identifying and pursuing new business opportunities, leading complex consulting engagements, and delivering exceptional value to clients. Candidates should be passionate about healthcare transformation, client service, and working in a collaborative, entrepreneurial environment.
Client Development
  • Develop and expand relationships with payer organizations, including medical and ancillary insurers.
  • Serve as a trusted advisor to client executives by bringing deep expertise in Payment Integrity, claims processing, reimbursement recovery, and provider revenue cycle operations.
  • Identify and originate opportunities within existing and prospective client accounts.
  • Participate in business development activities including client meetings, industry events, networking, and proposal development.
  • Support the sales cycle by helping shape solutions, work plans, pricing approaches, and value propositions.
  • Leverage market insights and industry expertise to position West Monroe as a trusted advisor and thought leader.
  • Collaborate with Healthcare Practice leadership, Business Development, and Marketing teams to support go-to-market activities and client growth initiatives.
  • Contribute to account growth through cross-selling and expansion of existing client relationships.
Client Delivery
  • Serve as an engagement leader on Payment Integrity and payer transformation engagements.
  • Manage all aspects of client delivery including scope, budget, staffing, workstreams, deliverables, and overall engagement profitability.
  • Provide strategic and operational guidance to clients on Payment Integrity programs, claims operations, reimbursement methodologies, and recovery optimization.
  • Communicate project status, risks, recommendations, and outcomes to executive stakeholders.
  • Ensure value creation is identified, measured, and articulated throughout the engagement lifecycle.
  • Mentor and develop consulting teams while maintaining high standards of quality and client service.
  • Act as a point of escalation for client concerns and drive issues through resolution.
  • Apply deep industry expertise to solve complex client challenges and deliver measurable business outcomes.
Practice Development
  • Contribute to the growth and evolution of West Monroe's Healthcare Practice through knowledge sharing, thought leadership, and solution development.
  • Develop Payment Integrity methodologies, tools, and best practices that enhance client delivery.
  • Support recruiting, onboarding, and mentoring efforts across the practice.
  • Actively participate in performance management and career development of team members.
  • Foster a culture of collaboration, inclusion, innovation, and continuous improvement.
  • Contribute to thought leadership through industry participation, conference speaking opportunities, and market-facing content.

Qualifications
  • Bachelor's degree required; advanced degree preferred.
  • 10+ years of consulting, healthcare payer, or healthcare operations experience with significant exposure to Payment Integrity, claims operations, reimbursement, and recovery programs.
  • Demonstrated experience leading complex client engagements and managing executive-level stakeholder relationships.
  • Proven ability to identify, develop, and support new business opportunities within existing and prospective accounts.
  • Strong understanding of healthcare payer operations, claims processing, reimbursement methodologies, provider payment models, and Payment Integrity programs.
  • Experience leading business and technology transformation initiatives within health insurance organizations.
  • Strong program and project management experience, including scope, budget, risk, issue, and stakeholder management.
  • Excellent verbal, written, and executive presentation skills.
  • Demonstrated ability to mentor and develop team members.
  • Commitment to fostering an inclusive culture and embracing diverse perspectives.

Based on pay transparency guidelines, a reasonable expectation for the salary range for this role is listed below. Information on our competitive total rewards package, including our bonus structure and benefits is here. Individual salaries are determined by evaluating a variety of factors including geography, experience, skills, education, and internal equity. Employees in proximity of our Seattle, Washington DC, Los Angeles, New York, and San Francisco offices will have a geographic premium applied to this salary scale.
Employees (and their families) are covered by medical, dental, vision, and basic life insurance. Employees are able to enroll in our company's 401k plan, purchase shares from our employee stock ownership program and be eligible to receive annual bonuses. Employees will also receive unlimited flexible time off and ten paid holidays throughout the calendar year. Eligibility for ten weeks of paid parental leave will also be available upon hire date.
National
$200,000-$250,000 USD
Other consultancies talk at you.
At West Monroe, we work with you.
We're a global business and technology consulting firm passionate about creating measurable value for our clients, delivering real-world solutions.
The combination of business and technology is not new, but how we bring them together is unique. We're fluent in both. We know that technology alone is not the answer, but how we apply it is. We rely on data to constantly adapt and solve new challenges. Actions that work today with outcomes that generate value for years to come.
At West Monroe, we zero in on the heart of the opportunity, getting to results faster and preparing people for what's next.
You'll feel the difference in how we work. We show up personally. We're right there in the room with you, co-creating through the challenges. With West Monroe, collaboration isn't a lofty promise, but a daily action. We work together with you to turn vision into clear action with lasting impact.
West Monroeis an Equal Employment Opportunity Employer
We believe in treating each employee and applicant for employment fairly and with dignity. We base our employment decisions on merit, experience, and potential, without regard to race, color, national origin, sex, sexual orientation, gender identity, marital status, age, religion, disability, veteran status, or any other characteristic prohibited by federal, state or local law. To learn more about diversity, equity and inclusion at West Monroe, visit www.westmonroe.com/inclusion. If you require a reasonable accommodation to participate in our recruiting process, please inquire by sending an email to recruiting@westmonroe.com.
Please review our current policy regarding use of generative artificial intelligence during the application process.
If you are based in California, we encourage you to read West Monroe's Notice at Collection for California residents, provided pursuant to the California Consumer Privacy Act (CCPA) and linked here.

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