Payment Integrity Analyst

Healthone Alliance

Dalton, US
Healthcare claims review
Fraud waste abuse identification
Cms regulations compliance
Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors

Job Summary

  • Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors.
  • A Payment Integrity Analyst reviews healthcare claims, payments, and billing to find errors, fraud, waste, or abuse, ensuring compliance with rules (like CMS) and policies, using strong data analysis, medical coding (CPT/ICD-10), and auditing skills to prevent financial loss and improve accuracy, often working with vendors and internal teams.
  • HealthOne provides a comprehensive benefits package including 401K with match, medical, dental, vision, and disability insurance, along with paid time off.

Matching Summary

Our mission is to enhance well-being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors.

Skills & Requirements

Must-have

  • healthcare claims review
  • fraud waste abuse identification
  • CMS regulations compliance
  • data analysis for trends
  • medical coding validation

Nice-to-have

  • compassionate workforce
  • neighbors helping neighbors
  • ethical empathetic economical efficient
  • continuous process improvement

Key Requirements

  • High School Diploma or GED
  • 3 years claims processing experience
  • Medical billing and coding experience
  • Proficiency in Word and Excel

Work Rights

Not specified

Tailored Resume

Cover Letter