Payment Integrity Analyst

Job Summary

A company is looking for a Payment Integrity Analyst - Data Mining & Savings Reporting.

Key Responsibilities

• Build, maintain, and enhance data pipelines for payment integrity and savings analysis
• Analyze healthcare claims data to identify improper payments and cost reduction opportunities
• Prepare and present savings reports and recommendations to stakeholders

Required Qualifications

• Bachelor's degree in healthcare administration, business, data science, or related field, or 5 years of equivalent experience
• 3+ years of experience in healthcare data analysis or related fields preferred
• Strong experience with SQL or modern data tools (e.g., Snowflake, dbt, Looker, Python)
• Experience with claims and payment integrity, especially in Medicare Advantage or New York Medicaid is a plus
• Intermediate knowledge of health insurance laws and regulations is a plus