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Payment Integrity Jobs (NOW HIRING)

Zelis

Senior Solution Advisor, Payment Integrity

Boston, MA · Remote

$148K - $148K/yr

Provide expertise on Payment Integrity portfolio, including PowerPoint creation and presentation, data analyses, evaluating product fit, and answering client/prospect questions. Strategic partner ...

Zelis

Senior Solution Advisor, Payment Integrity

Atlanta, GA · Remote

$131K - $131K/yr

Provide expertise on Payment Integrity portfolio, including PowerPoint creation and presentation, data analyses, evaluating product fit, and answering client/prospect questions. Strategic partner ...

Zelis

Senior Solution Advisor, Payment Integrity

Plano, TX · Remote

$130K - $131K/yr

Provide expertise on Payment Integrity portfolio, including PowerPoint creation and presentation, data analyses, evaluating product fit, and answering client/prospect questions. Strategic partner ...

Lyric

Payment Integrity Analyst - Data Mining

JOB SUMMARY The Payment Integrity Analyst (Data Mining) supports the Data Mining (DM) program by investigating payment errors due to incorrect processing of payment policies, contract terms, billing ...

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How much do payment integrity jobs pay per hour?

As of Jul 1, 2026, the average hourly pay for payment integrity in the United States is $17.99, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $19.71 per hour, depending on experience, location, and employer.

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. The role often requires knowledge of healthcare billing, claims processing, and data analysis tools.

What does payment integrity do?

Payment integrity professionals ensure that healthcare or insurance payments are accurate, authorized, and compliant with policies. They review claims, detect errors or fraud, and implement processes to prevent improper payments, often using data analysis and auditing tools.

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 the Payment Integrity position, and why are they important?

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 jobs pay 4000 a week without a degree?

In the field of Payment Integrity, high-paying roles such as claims managers or senior auditors can sometimes earn around $4,000 weekly, especially with extensive experience and specialized skills. These positions often require strong analytical abilities, knowledge of healthcare or insurance systems, and certifications like CPC or CPA, but may not require a traditional college degree.

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.

More about Payment Integrity jobs
What cities are hiring for Payment Integrity jobs? Cities with the most Payment Integrity job openings:
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What states have the most Payment Integrity jobs? States with the most job openings for Payment Integrity jobs include:
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Payment Integrity jobs near you
Infographic showing various Payment Integrity job openings in the United States as of June 2026, with employment types broken down into 78% Full Time, 16% Part Time, and 6% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $37,422 per year, or $18 per hour.
Supervisor, Payment Integrity-Spokane-In Office

Supervisor, Payment Integrity-Spokane-In Office

Molina Healthcare

Long Beach, CA • On-site

Full-time

Posted 18 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 192 frontline employees who took The Breakroom Quiz

143rd of 277 rated insurance

Job description

JOB DESCRIPTION Job Summary

Leads and supervises team responsible for payment integrity activities including recovery operations.  Responsible for performance, quality levels and establishing procedures and techniques that achieve optimal payment integrity operational standards and production targets.

Essential Job Duties

Supports implementation and execution of initiatives that include one or all of the following payment integrity activities: overpayment recovery, pre and post-pay coordination of benefits (COB), subrogation, premium enhancement managed service provider (MSP), datamining, pre-pay editing for correct coding and medical payment policies, and supplemental oversight and vendor inventory management processing activities.
Hires, trains, develops, mentors, and manages team responsible for executing projects and activities involving inventory management and prioritization, information reporting, data management, quality control procedures and workflows, and timely turnaround. 
Leads recovery processing, offset reconciliation, refund posting and reconciliation, provider dispute resolution, claim referrals and health plan special projects.
Ensures team meets or exceeds production targets.
Executes payment integrity programs that prioritize, identify and resolve payment/recovery issues.
Establishes procedures and techniques to achieve payment integrity operational standards.
Executes and monitors recovery inventory to ensure maintenance of performance and quality levels in payment integrity business products and processes.
Demonstrates expertise in claims processing, claims payment issue resolution, payment/adjustment error troubleshooting, and quality controls recovery adjustments.  
Professionally communicates and responds to health plan/provider inquiries and understands when to escalate issues for resolution as appropriate.
Manages inventory production queues, and assigns and prioritizes work. 
Analyzes complex data driven reports and develops actionable insights for resolution and leadership reporting. 
Collaborates with payment integrity leadership to resolve recovery issues in collaboration with health plan operations.  
Executes tasks and projects to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits, overpayment recovery, COB and subrogation - ensuring improved encounter submissions, general and administrative (G&A) reduction, and positive operational and financial outcomes for the payment integrity function.
 

Required Qualifications

At least 5 years of experience supporting health care operations, including 3 years payment integrity/claims experience, or equivalent combination of relevant education and experience.
Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
Strong organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software program(s) proficiency.
 

Preferred Qualifications

Management/leadership experience.
Managed care payor experience, preferably with Medicare/Medicaid.
Understanding of ICD-9/10CM, MS-, AP- and APR-DRG reimbursement.
Electronic medical record (EMR) and medical record repository experience.
 

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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