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Remote Payment Integrity Analyst Jobs in Texas (NOW HIRING)

Altegra Health

Remote Certified Coder

Dallas, TX · Remote

$22.25 - $30.50/hr

... and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to ... Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and ...

Altegra Health

Remote Certified Coder

Dallas, TX · On-site +1

$22.25 - $30.50/hr

... and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to ... Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and ...

Dane Street, LLC

Freelance Medical & Billing Coder

Houston, TX · Remote

$18 - $23.75/hr

... Payment integrity or professional bill review experience is strongly preferred. Out-of-network bill review experience is a plus. Experience working in a remote environment is preferred. Experience in ...

Sammons Industrial

Credit Analyst

Dallas, TX · On-site +1

Remote Type: Hybrid You belong at a company that treats you like an Owner! Sammons Industrial is an ... Analyze payment trends, account risk, and portfolio performance to prioritize collection efforts ...

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Remote Payment Integrity Analyst information

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 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 are the most commonly searched types of Payment Integrity Analyst jobs in Texas?

The most popular types of Payment Integrity Analyst jobs in Texas are:

What are popular job titles related to Remote Payment Integrity Analyst jobs in Texas?

For Remote Payment Integrity Analyst jobs in Texas, the most frequently searched job titles are:

What job categories do people searching Remote Payment Integrity Analyst jobs in Texas look for?

The top searched job categories for Remote Payment Integrity Analyst jobs in Texas are:

What cities in Texas are hiring for Remote Payment Integrity Analyst jobs?

Cities in Texas with the most Remote Payment Integrity Analyst job openings:

Remote Payment Integrity Analyst jobs near you

Remote Certified Coder

Altegra Health

Dallas, TX • Remote

$22.25 - $30.50/hr

Temporary

Re-posted 25 days ago

Job description

Company Description

Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in:

1. CMS HCC Risk Adjustment

2. HEDIS

3. Medical Record Reviews (Accreditation)

4. And more


Job Description

These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines).


Responsibilities:  

Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC group assignments as applicable.

Assign Altegra Health Flagged Event codes when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes.

Remain current on medical coding guidelines and reimbursement reporting requirements.

Check chart assignments every day and report accurately all hours worked on a weekly basis.

Report work-related concerns to assigned Coder Advocate and if not adequately addressed to Sr. Manager of Clinical Operations. 

Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines.

Comply with HIPAA laws and regulations.

Participate in testing and training as required by the Company.

Qualifications:  

Active nursing license (RN or LPN) and/or certified coder certification through AHIMA or AAPC required

At least one years' experience as a medical coder/abstractor.

Extensive knowledge of ICD-9-CM outpatient diagnosis coding guidelines (with knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements is preferred);

Ability to code using an ICD-9-CM code book (without using an encoder);

Strong clinical skills related to chronic illness diagnosis, treatment and management;

Reliability and a commitment to meeting tight deadlines (24-hour turnaround time on all assigned charts);

Personal discipline to work remotely without direct supervision;

Exemplary attention to detail and completeness-all medical coders must maintain minimum QA passing requirements based on HCC scoring model(HCCx < or equal to 5 and HCCm < or equal to 5);

Computer proficiency (including MS Windows, MS Office, and the Internet);

Must have high-speed Internet access, a home computer with a current Windows operating system, MS Internet Explorer (version 6.0.2 or better), and Adobe 6.0 or better;

Strong organization skills; interpersonal and customer service skills; written and oral communication skills; and analytical skills;

Knowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical chart documentation.


Qualifications

1 year of certified coding experience

Additional Information

All your information will be kept confidential according to EEO guidelines.

Apply