Payment Integrity Analyst I

Healthcare Management Administrators

Job Overview

Location

Remote

Salary

USD 73,000 - 81,000 yearly

Employment Type

Full-time

Work Arrangement

Remote

Sector

Healthcare & Medical

Experience Level

Mid-level (3-5 years)

Application Deadline

July 23, 2026

About the Company

Healthcare Management Administrators (HMA) stands as a premier third-party health plan administrator, serving the Pacific Northwest and beyond. The company is dedicated to providing customized, high-quality, and affordable healthcare plans to medium to large-sized employers, backed by best-in-class customer service. HMA has been consistently recognized as a ‘Washington’s Best Workplaces’ for three years, a testament to its inclusive, flexible, and engaging culture. Driven by its vision, ‘Proving What’s Possible in Healthcare™,’ and core values—People First!, Be Extraordinary, Work Courageously, Own It, and Win Together—HMA fosters an environment where employees can thrive. The organization seeks individuals who are deeply committed to helping others, adaptable to evolving environments, collaborative, and motivated by complex challenges. HMA offers a comprehensive total rewards package, including competitive compensation, extensive benefits, and abundant opportunities for professional development and growth, ensuring a supportive and balanced work-life experience.

Job Description

Healthcare Management Administrators (HMA) is a leading third-party health plan administrator, committed to delivering customized, high-quality, and affordable healthcare solutions to medium to large-sized employers. We pride ourselves on exceptional customer service and a culture that has earned us recognition as a ‘Washington’s Best Workplaces’ for three consecutive years.

Our vision, ‘Proving What’s Possible in Healthcare™,’ is built upon core values: People First!, Be Extraordinary, Work Courageously, Own It, and Win Together. These principles guide our decisions and drive our success. We are constantly seeking passionate individuals who thrive in dynamic environments, value teamwork, and are driven to tackle complex challenges.

As a Payment Integrity Analyst I, you will play a crucial role in ensuring the efficient and high-quality delivery of our payment integrity programs. Leveraging your claims expertise, program knowledge, and analytical capabilities, you will manage day-to-day operations for assigned programs, including CMS Demand Case and Subrogation. Your responsibilities will involve researching case questions, resolving issues, identifying process improvements, and ultimately contributing to a robust portfolio of payment integrity initiatives.

This remote position offers an inclusive, flexible, and engaging work environment, a competitive salary, comprehensive benefits, and ample opportunities for professional growth. Join HMA and contribute to meaningful work that makes a real difference in healthcare.

To apply for this role, click the Apply button on this page and follow the instructions.

Required Skills

ICD-10CPTClaims ProcessingData EntryExcelAnalytical SkillsProblem-solvingQuality AssuranceWorkload PrioritizationRoot Cause Analysis

Key Responsibilities

Provide strong analytical, problem-solving, and quality assurance skills to support efficient, accurate, and timely execution of assigned payment integrity programs.
Combine healthcare knowledge and technical skills using programs including QicLink and Excel to gather, assess, and perform detailed evaluations of data.
Identify issues, recommend solutions, and manage situations to resolution.
Identify, evaluate, and deliver new program improvements that increase cost containment results for HMA and its clients.
Track, manage, and report on daily program inventory for short-term prioritization and long-term strategic planning.
Evaluate existing business processes and policies and develop sustainable, measurable improvements.
Produce clear written documentation, such as Procedural Work Instructions or Job Aids, for core practices and business requirements for program changes.
Collaborate effectively with internal teams including Appeals, Claims, Client Success, and Stop Loss to deliver an informed, coordinated experience for clients and members.
Interact and communicate effectively with payment integrity program vendors and government agencies to meet program expectations.
Maintain current knowledge of claims processing, job-related systems, and associated government regulations, and pursue relevant education and training.

Qualifications

High School Diploma required.
ICD-10 & CPT experience required.
3-5+ years of claims processing experience within the insurance industry.
2+ years of data entry experience.
Intermediate Excel skills with the ability to build effective spreadsheets and manipulate data.
Able to manage a complex daily queue and prioritize workload effectively.
Skilled in identifying root causes of issues through detailed investigation and inquiry.
Able to analyze impacts of potential actions or decisions to determine the optimal choice.

Benefits & Perks

Seventeen (IC) days paid time off (individual contributors).
Twelve paid holidays.
Two paid personal and one paid volunteer day.
Company-subsidized medical, dental, vision, and prescription insurance.
Company-paid disability, life, and AD&D insurances.
Voluntary insurances.
HSA and FSA pre-tax programs.
401(k) retirement plan with company match.
Annual $500 wellness incentive and a $600 wellness reimbursement.
Remote work and continuing education reimbursements.
Discount program.
Parental leave.
Up to $1,000 annual charitable giving match.
Flexible work schedules that support people in all time zones across the US.
Performance management program designed to elevate career growth opportunities.
Collaborative work culture where every team member can thrive.
In-person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party.

How to Apply

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The healthcare administration sector in the United States is rapidly evolving, driven by complex regulatory changes and a demand for efficient cost containment. This Payment Integrity Analyst I role is crucial for ensuring the efficient and high-quality delivery of payment integrity programs. Key responsibilities include leveraging claims expertise, program knowledge, and strong data analytics capabilities. Proficiency with tools like QicLink and Excel is essential for detailed data evaluations. This position directly impacts HMA's financial integrity by optimizing payment programs, reducing waste, and ensuring compliance. It significantly contributes to client cost savings and organizational growth within the dynamic US healthcare landscape.