Quality Analyst – Data Mining, Payment Integrity
About The Position
The Quality Analyst – Data Mining, Payment Integrity plays a key role in ensuring the accuracy, quality, and consistency of audit work performed within the Data Mining program. This position is responsible for reviewing completed audit findings, validating overpayment opportunities, confirming claim repricing accuracy and supporting documentation, and ensuring audit work aligns with client requirements, coding guidelines, pricing rules, and claim payment methodologies. The ideal candidate brings strong healthcare claims knowledge, analytical thinking, attention to detail, and the ability to provide clear feedback that supports auditor performance, continuous improvement, and stronger recovery outcomes.
Requirements
- Strong healthcare claims knowledge
- Analytical thinking
- Attention to detail
Responsibilities
- Reviewing completed audit findings
- Validating overpayment opportunities
- Confirming claim repricing accuracy and supporting documentation
- Ensuring audit work aligns with client requirements, coding guidelines, pricing rules, and claim payment methodologies
- Providing clear feedback that supports auditor performance, continuous improvement, and stronger recovery outcomes
Benefits
- Up to 10% annual travel (for team meetings and limited client onsite engagements.)
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
