Payment Integrity Analyst

Job Summary

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

Key Responsibilities

• Investigate and validate payment terms and discrepancies across sources to determine correct reimbursement
• Collaborate with the team to analyze claims, document findings, and maintain accurate case notes
• Track outcomes and recommend improvements to streamline processes and reduce incorrect payments

Required Qualifications

• Minimum of one (1) year of experience in healthcare, such as health insurance or claims processing
• Minimum of one (1) year of experience auditing medical claims for improper payments
• Minimum of one (1) year of experience performing data analytics with large data sets
• Minimum of one (1) year of experience with medical billing codes and understanding of medical terminology
• Bachelor's degree in business or healthcare-related field preferred