Payment Integrity Specialist
Virtual Vocations Inc
Responsible for reviewing and analyzing underpayment records and managed care contracts, the full-time Payment Integrity Specialist will ensure compliance with contract terms and maximize reimbursement while working remotely. Key responsibilities Review and maintain underpayment records and managed care contracts to ensure accurate billing and reimbursement Develop and document standard operating procedures to ensure consistency in claim adjudication and compliance Conduct extensive research and analysis on managed care issues, facilitating communication and education with internal departments and payors Required qualifications Associate degree in healthcare or business-related field, or a minimum of three years of prior healthcare revenue cycle experience Experience working with Excel spreadsheets is required Minimum of two years of prior healthcare experience with an understanding of healthcare reimbursement is preferred Ability to meet standard productivity requirements before transitioning to a home-based position
$23 - $26 per hour
...in the various TPA systems. ~Assist with SCA negotiations. Qualifications ~At least 5 years of experience in a TPA, Payment Integrity, Revenue Cycle management, and/or coding. ~High school diploma. ~Knowledge of medical terminology and medical billing terminology...SuggestedFull timeWork at office$70k - $86k
Role Description The Payment Integrity Specialist plays a critical role in ensuring accurate reimbursement and regulatory compliance across payer relationships. This position is responsible for monitoring audits and refund requests, auditing payments against payer contracts...SuggestedFull timeContract workLocal area$68k
...application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Payment Integration Specialist Full Time White Plains, NY, US 30+ days ago Requisition ID: 1026 Salary: $68,000.00 Annually Job Title: Payment...SuggestedFull timeRemote work- Senior Specialist, Talent Acquisition at nTech Workforce Title: Payment Integrity Specialist Location: 100 % Remote, but Candidates must be based in EST or CST and must be comfortable working EST-hours Terms of Employment This position is 100% remote. Candidates must...SuggestedContract workRemote work
- A leading healthcare firm is seeking a Payment Integrity Specialist for a fully remote role. Candidates must be based in EST or CST and comfortable with EST hours. Responsibilities include analyzing medical records, handling claims, and utilizing systems like Facets and...SuggestedRemote jobContract work
- A healthcare staffing agency is seeking a Payment Posting Specialist to ensure timely and accurate posting of accounts. The role includes reconciling... ...in CPT and ICD.9 codes. This position promotes revenue integrity and requires effective communication and data organization...
- Unlimit is seeking a Payment Methods Specialist / Senior Payment Methods Specialist to lead the full lifecycle of Alternative Payment Methods (APMs). This role requires strong payment expertise, collaboration with technical teams, and excellent analytical skills. You will...Work at office
- ...Summary Provides lead level analyst support for health plan payment integrity activities. Partners with leaders and functional... ...Certified Business Analysis Professional (CBAP) or Certified Coding Specialist (CCS) certification. • Project management experience....Temporary workWork at officeRemote work
$107.7k - $199.3k
...maximizing effective implementation and results. ~Organizes work teams, drives consensus, and ensures end-to-end policy/process integrity to accomplish project work. ~Assists functional and project leaders in areas such as facilitation, analysis, process mapping,...Full timePart timeWork at officeRemote workFlexible hours- ...Payment Integrity Drg Coding & Clinical Validation Analyst The Payment Integrity DRG Coding & Clinical Validation Analyst position has an extensive background in acute facility-based clinical documentation, and/or inpatient coding and has a high level of understanding...Work experience placement
$75k - $100k
...Senior Analyst, Edits | Payment Integrity (Remote) Category: Analytics and Emerging Digital Technologies Main location: United States, Tennessee, Knoxville Alternate Location(s): United States, Georgia, Atlanta United States, North Carolina, Charlotte...Full timeLocal areaRemote work- Cotiviti is seeking a Payment Accuracy Specialist 2 to join our healthcare recovery team. The role focuses on developing audit concepts and training team members while ensuring compliance with healthcare regulations. The ideal candidate should possess a high school diploma...Work at office
- Role Description Leads and supervises team responsible for payment integrity activities including recovery operations. Responsible for performance, quality levels and establishing procedures and techniques that achieve optimal payment integrity operational standards and...Full timeWork at office
$73k - $81k
Role Description The Payment Integrity Analyst ensures assigned payment integrity programs are delivered efficiently and with high quality. Using claims expertise, program knowledge, and analytics capability, this person will provide the day-to-day management of assigned...Full timeTemporary workSummer workWork at officeRemote workNight shift$69.4k - $99.2k
...leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. The Payment Integrity Analytics, Senior Analyst plays a critical, client-facing role supporting state Medicaid agencies by applying existing fraud,...Full timeWork at officeRemote workFlexible hours$24.2 - $36.3 per hour
Role Description The Payment Integrity Analyst (COB) supports the Coordination of Benefits (COB) program by investigating and validating other insurance coverage, resolving conflicting eligibility information, and establishing the correct order of liability (primary vs....Full time- ...Title: Medicare SME- Payment Integrity Analyst Duration : 12 months Location : Remote This resource will implement a process to test end-to-end common Medicare Advantage leakage scenarios across multiple Medicare service categories to rapidly...Remote work
$66.94k - $101.26k
...The Payment Integrity Analyst is responsible for accurately reviewing and completing pre- and post pay claim audits based on client, policy, industry standards and/or CMS guidelines. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes, and completes internal...Minimum wageFull timeWork experience placementWork at officeLocal areaRemote workFlexible hours$60k - $65k
...are seeking a highly motivated and detail-oriented Revenue Integrity Training Specialist to join our team. This dual-role position is crucial for... ...responsible for conducting rigorous audits to identify and resolve payment discrepancies and denial trends, while simultaneously...Full timeContract workWork at officeWork from homeHome office- Role Description The Senior Lead of Payment Integrity is responsible for the end-to-end performance, satisfaction, and operational excellence of the company’s carrier network. This role develops, manages, and strengthens strategic carrier relationships while ensuring accuracy...Full time
- ...Payment Posting SpecialistJob TitlePayment Posting Specialist – Revenue CycleLocationLafayette, LAPosition SummarySUN Behavioral Health is seeking a detail-oriented... ...payment discrepancies, and ensuring the integrity of accounts receivable records. This position is...Temporary workWork experience placementLocal area
- Role Description Assures integrity and balancing of patient accounting system A/R, Electronic Payments, Adjustments and Refunds. Ensures all payments for all clients are reconciled daily. Manages day to day payment posting process for all assigned clients. Ensures accuracy...Full timeWork experience placement
- The Payment Integrity Supervisor is responsible for the daily activities of payment integrity team related to quality assurance and provider appeals. The Supervisor manages and prioritizes staff daily work assignments necessary to ensure the timely and accurate processing...Daily paidMinimum wageFull timeWork experience placementWork at officeLocal areaRemote workFlexible hours
$23.65 - $35.48 per hour
...to simplifying the business of care by preventing inaccurate payments and reducing overall waste in the healthcare ecosystem, enabling... ...recognized as 2025 Best in KLAS for Pre-Payment Accuracy and Integrity and is HI-TRUST and SOC2 certified, and a recipient of the 202...Full timeVisa sponsorship- ...focuses on analyzing customer-specific value opportunities using SQL and advanced Excel while improving models and supporting payment integrity processes in healthcare. The ideal candidate will have experience in auditing medical claims and prove innovative in identifying...
- Healthcare Management Administrators seeks a Payment Integrity Analyst to manage assigned programs, including CMS Demand Case and Subrogation, using claims expertise and analytics. You will research questions, resolve issues and contribute to process improvements for a...Remote job
- General Summary Reporting to the Manager, Payment Variance and Resolution, the RI Analyst, Payment Variance and Resolution is responsible... ..., provider, and ambulatory revenue cycle operations. Revenue Integrity (RI) is a distinct function that drives proactive charge...Full timeContract workWork at officeShift work
$19 - $21 per hour
Role Description The Conditional Payment Specialist is responsible for working with Medicare and its contractors to obtain documentation, ensure... ...all services are completed with the highest quality and integrity and all work is in full compliance with client contractual...Full timeFor contractorsRemote workMonday to Friday- ...Payment and Reconciliation Specialist- Hybrid Jacksonville, Florida Healthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based...Work at office
$20.5 - $29.23 per hour
...Payment Posting Specialist Hybrid Stayton, OR 97383 Overview Salary Range $20.50 - $29.23 Hourly Job Shift Day Education Level High School Travel... ...contribute to resolving variances, and help maintain the integrity of the revenue cycle. Your attention to detail and follow-...Hourly payFull timeMonday to FridayShift work
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