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Remote Payment Integrity Analyst Jobs in Ohio (NOW HIRING)

Molina Healthcare

Medical Review Nurse (RN)

Columbus, OH · Remote

$29.05 - $56.64/hr

... payment integrity analytical team; makes decisions and recommendations pertinent to clinical experience. • Prepares and presents cases representing Molina, along with the chief medical officer ...

VIVA USA INC

Help Desk Analyst

Columbus, OH · On-site +1

$19.75 - $27/hr

Remote The Help Desk Analyst provides Tier 1 technical assistance and program support for statewide ... Program & System Analysis Analyze payment processing errors and recommend corrective actions.

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Claims Analyst

Columbus, OH · On-site +1

Financial Integrity & Legal Compliance: Comprehensively manage and reconcile all financial aspects ... Possess a deep understanding of the distinctions between various payment methods and the strategic ...

Booz Allen Hamilton, Inc.

Data Analyst

Dayton, OH · On-site +1

$61K - $141K/yr

Remote Work: No Job Number: R0241818 Location: Dayton,OH,US Share job via: Share Data Analyst The ... support system integrity and performance monitoring. * Assist in supporting Policy Business ...

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Remote Payment Integrity Analyst information

How much does a remote payment integrity analyst make?

A remote payment integrity analyst typically earns between $50,000 and $80,000 annually, depending on experience, location, and certifications. The role often requires strong analytical skills and familiarity with healthcare or financial systems, with some positions offering additional bonuses or benefits for remote work arrangements.

What are the key skills and qualifications needed to thrive as a remote payment integrity analyst, and why are they important?

To excel as a Remote Payment Integrity Analyst, you need strong analytical skills, experience in healthcare claims or payment analysis, and a bachelor’s degree in a related field. Familiarity with data analysis tools (such as Excel, SQL, or claims processing systems) and knowledge of industry regulations like HIPAA are typically required. Attention to detail, problem-solving abilities, and effective communication are vital soft skills for investigating discrepancies and collaborating with stakeholders. These competencies ensure the accurate identification of improper payments, cost savings, and compliance within healthcare organizations.

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

AspectRemote Payment Integrity AnalystRemote Claims Auditor
Required CredentialsCertifications in healthcare compliance, coding, or auditingCertifications in claims processing, auditing, or healthcare reimbursement
Work EnvironmentRemote, healthcare or insurance companiesRemote, insurance or healthcare organizations
Industry UsageHealthcare payers, insurance companiesInsurance companies, third-party administrators
Common Search IntentUnderstanding roles in payment integrity and fraud preventionAuditing claims for accuracy and compliance

The Remote Payment Integrity Analyst focuses on detecting and preventing improper payments, fraud, and abuse within healthcare claims, often requiring compliance and coding certifications. In contrast, the Remote Claims Auditor reviews claims for accuracy and adherence to policies, typically with auditing certifications. Both roles are remote, industry-specific, and involve analyzing healthcare or insurance claims, but they emphasize different aspects of claims management and compliance.

What is a remote payment integrity analyst?

A Remote Payment Integrity Analyst is a professional who works from a remote location to review healthcare or insurance claims for accuracy, compliance, and potential fraud. Their primary role is to ensure that payments made by insurance companies or healthcare providers are correct and align with policy guidelines. They use data analysis, auditing processes, and investigative techniques to identify improper payments or billing errors. This helps organizations recover overpayments, prevent financial losses, and maintain regulatory compliance. Remote Payment Integrity Analysts typically work for health insurers, government agencies, or third-party vendors.

How does a remote payment integrity analyst typically collaborate with other departments to resolve payment discrepancies?

As a Remote Payment Integrity Analyst, you'll regularly work with teams such as billing, claims, and provider relations to investigate and resolve payment discrepancies. Clear communication—often via email, virtual meetings, or internal platforms—is crucial for gathering documentation, clarifying complex cases, and ensuring timely resolution. Collaboration may also involve sharing findings or trends to help improve overall payment processes and prevent future errors. This cross-functional teamwork is essential for maintaining accuracy and compliance in healthcare or insurance payment systems.
What are the most commonly searched types of Payment Integrity Analyst jobs in Ohio? The most popular types of Payment Integrity Analyst jobs in Ohio are:
What are popular job titles related to Remote Payment Integrity Analyst jobs in Ohio? For Remote Payment Integrity Analyst jobs in Ohio, the most frequently searched job titles are:
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Remote Payment Integrity Analyst jobs near you

Epic Revenue Integrity Analyst

Global Associates

Dayton, OH • Remote

$85K/yr

Full-time

Re-posted yesterday

Job description

Title: Senior Revenue Integrity Analyst

Location: Remote

Length: Contract-To-Hire

Job Details:

The senior revenue integrity analyst is responsible for planning and oversight of the revenue integrity analysts’ performance of essential department accountabilities, including reporting to department leadership about goal status. This position will be responsible for all aspects related to revenue integrity, including maintaining work queues, understanding, and applying yearly regulatory changes, maintaining the chargemaster, and preventing revenue leakage. The senior revenue integrity analyst works accounts in assigned Revenue Integrity work queues to facilitate accurate, compliant billing of patient accounts and assists revenue integrity analysts with completion of tasks and work queues. The position will be certified in Epic CDM Management/Revenue Integrity to create, edit, delete and research various CDM requests for all hospital departments for both hospital and professional billing. 
The senior analyst is responsible for establishing and enforcing the hospitals’ pricing, coding, and regulatory changes. The incumbent needs to have knowledge of how billing and the CDM interacts for chargemaster build and will assist in hospital decision making related to chargemaster requests. The position will also provide operational analytical support with regards to reimbursement, charge lag, revenue trends, and other revenue related items. The senior revenue integrity analyst will coordinate and collaborate the above actions with, but not limited to, Health Information Management, Information Systems, Billing, Finance and Operations.

Department Specific Job Details:

Education

  • Bachelor’s degree in Health Information Management, Finance or related field required
  • Masters preferred

Experience Required

  • 6-10 years of revenue integrity, analyst, etc. experience in healthcare
  • Experience with EPIC electronic health record
  • EPIC CDM/Revenue Integrity (HB and PB) certification within 6 months of employment required
  • Ability to research CPT and regulatory requirements
  • Experience with CPT and HCPCS codes and interpreting CPT guidance
  • Experience in healthcare billing, CMS Medicare and Medicaid reimbursement methodologies
  • Proficiency in Microsoft Office Tools (Outlook, Excel)

Preferred qualifications/skills

  • Trisus (Craneware) chargemaster experience
  • Strata experience
  • Registered Health Information Administrator (RHIA) Certification