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Payment Integrity Jobs in Washington (NOW HIRING)

Office of Personnel Management

Program Manager

Washington, DC · On-site +1

$169K - $197K/yr

  • Medical

Direct administrative program integrity reviews involving potential fraud, waste, abuse, improper payments, control weaknesses, and other program integrity risks affecting Federal health benefits ...

Office of Personnel Management

Program Manager

Washington, DC · On-site +1

$169K - $197K/yr

  • Medical

Direct administrative program integrity reviews involving potential fraud, waste, abuse, improper payments, control weaknesses, and other program integrity risks affecting Federal health benefits ...

kgs

Risk & Controls Management Analyst (REMOTE)

Washington, DC · Remote

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Prepare and provide the annual audit-ready Payment Integrity Information Act (PIIA) of 2019 (as updated) report of estimated dollar amount of improper payments. Education and Experience: Required:

New

kgs

Risk & Controls Management Analyst (REMOTE)

Washington, DC · Remote

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Prepare and provide the annual audit-ready Payment Integrity Information Act (PIIA) of 2019 (as updated) report of estimated dollar amount of improper payments. Education and Experience: Required:

New

Guidehouse

Medical Coding & Reimbursement Specialist

Mclean, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

What You Will Need: * 2+ years of experience in medical coding, reimbursement, payment integrity, auditing, compliance, revenue cycle, or claims operations. * Strong knowledge of CPT, HCPCS, ICD-10 ...

New

Guidehouse

Medical Coding & Reimbursement Specialist

Mclean, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

What You Will Need: * 5+ years of experience in medical coding, reimbursement, payment integrity, auditing, compliance, revenue cycle, or claims operations. * Strong knowledge of CPT, HCPCS, ICD-10 ...

New

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Payment Integrity information

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How much do payment integrity jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for payment integrity in Washington is $20.38, according to ZipRecruiter salary data. Most workers in this role earn between $17.40 and $22.31 per hour, depending on experience, location, and employer.

What are some typical challenges faced in a payment integrity position?

Professionals in Payment Integrity roles often encounter complex claims data, evolving regulatory requirements, and the need to identify subtle errors or irregular billing patterns with precision. Balancing high-quality analysis with efficiency, while navigating between multiple systems and large datasets, can be challenging. The role often requires close collaboration with other departments such as provider relations, compliance, and IT to resolve issues and implement process improvements. Successfully overcoming these challenges helps organizations minimize losses, maintain compliance, and promote fair payment practices.

What does a payment integrity specialist do?

A payment integrity specialist reviews healthcare claims and payments to identify and prevent errors, fraud, and overpayments. They analyze data, ensure compliance with regulations, and use tools like claims processing software to improve payment accuracy and reduce financial losses.

What are the key skills and qualifications needed to thrive in a payment integrity position?

To thrive in a Payment Integrity role, you need strong analytical skills, attention to detail, and a solid understanding of healthcare claims, payment processes, or insurance operations, often supported by a bachelor's degree in a related field. Familiarity with claims processing platforms, data analysis tools such as Excel or SQL, and knowledge of industry certifications (like CPC or CPMA) is valuable. Exceptional problem-solving abilities, effective communication, and the capacity to collaborate with cross-functional teams set outstanding candidates apart. These skills are crucial for accurately identifying discrepancies, preventing fraud, and ensuring efficient payment processes in complex healthcare or financial settings.

What is a payment integrity job?

A Payment Integrity job involves reviewing healthcare claims, payments, and policies to identify errors, prevent fraud, and ensure compliance with regulations. Professionals in this role analyze data, conduct audits, and collaborate with providers and payers to recover overpayments and prevent improper billing. Their goal is to enhance cost efficiency, reduce financial losses, and ensure accurate reimbursement in the healthcare system.

What are popular job titles related to Payment Integrity jobs in Washington?

For Payment Integrity jobs in Washington, the most frequently searched job titles are:

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

The top searched job categories for Payment Integrity jobs in Washington are:

Payment Integrity jobs near you
Infographic showing various Payment Integrity job openings in Washington as of August 2026, with employment types broken down into 81% Full Time, 16% Part Time, and 3% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $42,384 per year, or $20.4 per hour.

Managed Care Payment Integrity Liaison

MedStar Health

Columbia, MD • On-site

$65K - $117K/yr

Full-time

Re-posted 20 days ago

Medstar Health rating

7.8

Company rating: 7.8 out of 10

Based on 239 frontline employees who took The Breakroom Quiz

130th of 887 rated healthcare providers

Job description

About the Job
General Summary of Position
The Managed Care Payment Integrity Associate will bridge the gap between managed care and revenue cycle ensuring accurate reimbursement and minimizing payment delays. This position focuses heavily on analyzing resolving and preventing denials and underpayments from Commercial Managed Medicare and Managed Medicaid payers. In addition this Associate will have the responsibility of tracking payer policies and informing key stakeholders of the operational and/or financial impact of any change.
Primary Duties and Responsibilities
  • Leads investigations into denial trends and payment discrepancies related to managed care contracts. Escalates claims and hold payers accountable for resolution.
  • Updates payer-specific escalation logs with relevant timely and informative data.
  • Collaborates with payer representatives to resolve systemic underpayments and denials. Develops and maintains payer-specific denial prevention strategies.
  • Tracks and reviews updates from payers including policy bulletins coverage determinations medical necessity guidelines coding updates and reimbursement rule changes. Maintains a comprehensive database of policy changes with effective dates impacted services and required organizational actions.
  • Analyzes the potential operational financial and compliance impacts of new or revised policies and communicates appropriately to key stakeholders.
  • Proactively identifies and addresses operational issues with payers. Gathers feedback from Revenue Cycle teams regarding contract implementation and performance.
  • Actively participates in all payer meetings focused on claim issue resolution.
  • Maintains effective working relationships and communications with internal staff MedStar Health leaders and external managed care payers.

Minimal Qualifications
Education
  • Bachelor's degree in Healthcare Administration Finance Business or related field required or
  • Associate's degree with 12-15 years of relevant experience required

Experience
  • 5-7 years Experience in both managed care operations and/or tertiary hospital revenue cycle. required and
  • Deep understanding of managed care reimbursement models (DRG APC per diem etc.) required and
  • Strong working knowledge of denials underpayments and appeals workflows as well as billing compliance and payer policies required and
  • Experience with all forms of Managed Care plans and commercial payer negotiations. preferred and
  • Familiarity with payer portals and contract modeling tools. preferred and
  • Familiarity with Maryland's Health Services Cost Review Commission. preferred and
  • Familiarity with EPIC. preferred

Knowledge Skills and Abilities
  • Hospital billing systems
  • Communication collaboration and critical thinking skills
  • Microsoft Excel

This position has a hiring range of
USD $65,062.00 - USD $117,291.00 /Yr.

What Medstar Health employees say

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Benefits

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About Medstar Health

Sourced by ZipRecruiter

MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Columbia, MD, US

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