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Senior Payment Integrity Analyst Jobs (NOW HIRING)

HMSA

Analyst, Payment Integrity

Honolulu, HI · Hybrid

* Research and Analysis * Serve as contact for external vendors and internal departments to support operations and payment integrity activities. * Research and respond to low to high priority complex ...

Jj

Senior Payment Analyst

Warsaw, IN · On-site

$82K - $102K/yr

Job Overview The Senior Payment Analyst supports DePuy Synthes' commercial performance by ensuring accurate, timely, and compliant processing of customer rebate & administrative fee payments. This ...

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Senior Payment Integrity Analyst information

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$53.5K

$109.8K

$142.5K

How much do senior payment integrity analyst jobs pay per year?

As of Jun 16, 2026, the average yearly pay for senior payment integrity analyst in the United States is $109,846.00, according to ZipRecruiter salary data. Most workers in this role earn between $90,500.00 and $137,000.00 per year, depending on experience, location, and employer.

How much does a senior payment integrity analyst make at HealthEdge?

The salary for a Senior Payment Integrity Analyst typically ranges from $70,000 to $100,000 annually, depending on experience, location, and certifications. This role involves analyzing payment data, identifying discrepancies, and ensuring compliance within healthcare payment systems.

What is a Senior Payment Integrity Analyst?

A Senior Payment Integrity Analyst is a professional responsible for ensuring that healthcare or financial claims are accurate, compliant, and free of errors or fraud. They analyze large datasets to identify discrepancies, overpayments, underpayments, or potentially fraudulent activity. Senior analysts often lead investigations, collaborate with internal teams, and recommend process improvements to enhance payment accuracy and reduce financial risk. This role typically requires strong analytical skills, knowledge of industry regulations, and experience with claims processing systems.

How much does a revenue integrity analyst make in Texas?

A Senior Payment Integrity Analyst typically earns between $70,000 and $90,000 annually in Texas, depending on experience, certifications, and the employer. The role involves analyzing payment data, identifying billing discrepancies, and ensuring revenue accuracy within healthcare or financial organizations.

What is the difference between Senior Payment Integrity Analyst vs Payment Integrity Analyst?

AspectSenior Payment Integrity AnalystPayment Integrity Analyst
Required CredentialsBachelor's degree, certifications like CPC or CPHQ often preferredBachelor's degree, relevant certifications optional
Work EnvironmentHealthcare or insurance companies, government agenciesHealthcare insurers, third-party administrators
Employer & Industry UsageUsed in healthcare, insurance, government sectorsCommon in healthcare insurance companies
Comparison Search IntentUnderstanding senior roles and responsibilitiesEntry to mid-level payment integrity roles

The Senior Payment Integrity Analyst typically has more experience, advanced certifications, and handles complex cases, whereas the Payment Integrity Analyst focuses on routine audits and claims review. Both roles are vital in healthcare and insurance sectors, but the senior position involves greater responsibility and oversight.

What are the main challenges a Senior Payment Integrity Analyst might face when working with cross-functional teams?

A Senior Payment Integrity Analyst often works closely with teams such as claims processing, IT, and compliance. One of the main challenges in this collaborative environment is ensuring clear communication and alignment on complex data and regulatory requirements. Analysts must often translate analytical findings into actionable recommendations for non-technical colleagues, which requires strong interpersonal skills and adaptability. Navigating different priorities and timelines across departments can also be challenging, but it provides valuable experience in project management and cross-functional leadership.

What does a payment integrity analyst do?

A payment integrity analyst reviews and investigates healthcare or insurance claims to detect and prevent fraudulent, erroneous, or improper payments. They analyze data, identify patterns of abuse, and ensure compliance with policies, often using specialized tools and data analysis skills. Their work helps organizations reduce financial losses and maintain accurate billing processes.

What is an integrity analyst?

An integrity analyst is a professional responsible for reviewing and investigating data, transactions, or processes to detect and prevent fraud, errors, or compliance issues. In payment integrity roles, they analyze claims and payment data using tools like data analytics software to ensure accuracy and prevent improper payments.

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

To thrive as a Senior Payment Integrity Analyst, you need strong analytical abilities, in-depth knowledge of healthcare claims processing, and experience in data analysis, often supported by a degree in finance, healthcare administration, or a related field. Familiarity with claims adjudication systems, data mining tools like SAS or SQL, and certification such as Certified Professional Coder (CPC) is typically required. Excellent problem-solving, attention to detail, and strong communication skills are essential for identifying errors and collaborating with cross-functional teams. These skills ensure accurate claims processing, minimize financial losses, and support regulatory compliance in healthcare organizations.
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Senior Payment Integrity Analyst jobs near you
Infographic showing various Senior Payment Integrity Analyst job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 67% In-person, and 33% Remote job distribution, with an average salary of $109,846 per year, or $52.8 per hour.
Senior Analyst - Payment Integrity Analytics

Senior Analyst - Payment Integrity Analytics

Gainwell Technologies LLC

Austin, TX

$69K - $99K/yr

Other

Medical, Life, Retirement, PTO

Posted 19 days ago

Gainwell Technologies rating

7.7

Company rating: 7.7 out of 10

Based on 72 frontline employees who took The Breakroom Quiz

109th of 190 rated software companies

Job description

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You'll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.
Summary
The Payment Integrity Analytics, Senior Analyst plays a critical, client-facing role supporting state Medicaid agencies by applying existing fraud, waste, and abuse (FWA) analytic models to Medicaid claims data and delivering monthly, prequalified FWA lead referrals. This role emphasizes producing clear, defensible, and actionable intelligence that can be readily understood and operationalized by state Office of Inspector General (OIG) staff and other program integrity stakeholders.
The analyst serves as a trusted analytical partner to the state, presenting and explaining FWA leads, responding to follow-up questions, and supporting investigations through data analysis, documentation, and, when required, testimony and travel related to fraud investigations. The role also includes translating state feedback, investigative outcomes, and audit results into recommendations for analytic improvements, program integrity controls, and broader Medicaid policy or operational changes.
Your role in our mission
  • Apply established FWA analytic models to Medicaid claims data to identify potential fraud, waste, and abuse.
  • Deliver monthly, prequalified FWA lead referral reports on a consistent and reliable cadence.
  • Produce reports that clearly articulate the analytic rationale, suspected behavior, and investigative relevance of each lead.
  • Ensure all outputs are defensible, audit-ready, and written for non-technical investigative and policy audiences.
  • Present FWA lead referrals to state Medicaid program integrity and OIG staff.
  • Explain findings, methodologies, and data sources in support of state investigations.
  • Respond to follow-up questions and perform supplemental or ad hoc analyses related to specific referrals.
  • Support investigations through documentation, exhibits, and data interpretation.
  • Participate in meetings, briefings, and, as needed, provide testimony or in-person investigative support (travel may be required).
  • Provide structured feedback to analytics and data science teams on model performance and data quality.
  • Recommend enhancements, modifications, or corrections to existing analytic models.
  • Translate state feedback and investigative outcomes into prioritized analytics roadmap items.
  • Analyze outcomes of other audit programs to identify systemic program integrity vulnerabilities.
  • Develop data-driven recommendations related to claims adjudication processes, controls, or edits.
  • Advise states on potential policy, regulatory, or statutory changes to reduce FWA risk and close program gaps.

What we are looking for
  • Extensive experience analyzing Medicaid claims and encounter data to identify fraud, waste, and abuse. (5+ years)
  • Deep knowledge of Medicaid program integrity, including common FWA schemes, audit methodologies, and investigative workflows. (5+ years)
  • Prepare reports and presentations documenting analytic methods and results for internal and external customers (4+ years)
  • Experience reading, interpreting, and applying Medicaid policy, regulations, state plan language, and related guidance.
  • Strong written and verbal communication skills, with experience presenting analytic findings to state agencies, Offices of Inspector General, or other oversight bodies.

Preferreed qualifications
  • Prior experience working directly with state Medicaid agencies and/or Offices of Inspector General is strongly preferred.
  • Professional certifications such as Certified Professional Coder (CPC), Certified Fraud Examiner (CFE), and/or Accredited Health Care Fraud Investigator (AHFI) are preferred.

What you should expect in this role
  • Regular interaction with state Medicaid and OIG stakeholders
  • Fully remote opportunity with the option to work anywhere within the United States
  • Monthly delivery cadence tied to investigative operations
  • Balance of independent analytical work and client-facing collaboration
  • Occasional travel and participation in investigative or hearing-related activities (Up to 25%)
  • Video cameras must be used during all interviews, as well as during the initial week of orientation
  • The Deadline to submit applications for this posting is June 14, 2026.

The pay range for this position is $69,400.00 - $99,200.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

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About Gainwell Technologies

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With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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