Quality Analyst – Data Mining, Payment Integrity

About Our Client:This organization operates within the healthcare payment integrity sector, focusing on data mining to identify and recover overpayments. The team addresses challenges in ensuring accurate audit processes, adherence to coding guidelines, and compliance with client-specific pricing rules. Their work supports improved claim payment accuracy and recovery outcomes.About the Opportunity:The Quality Analyst – Data Mining, Payment Integrity is responsible for ensuring the accuracy, quality, and consistency of audit work within the Data Mining program. This role involves reviewing audit findings, validating overpayment opportunities, confirming claim repricing accuracy, and ensuring alignment with client requirements and industry standards. The position plays a critical part in supporting auditor performance and enhancing recovery results.Responsibilities:• Review completed audit findings for accuracy and consistency• Validate overpayment opportunities identified by audits• Confirm claim repricing accuracy and supporting documentation• Ensure audit work complies with client requirements, coding guidelines, pricing rules, and claim payment methodologies• Provide clear feedback to auditors to support performance improvement and stronger recovery outcomesRequirements:• Strong knowledge of healthcare claims• Analytical thinking and attention to detail• Ability to communicate feedback effectivelyPay Range and Compensation Package:• Salary Range: $75,000 – $90,000 based on experience, skills, and qualifications• Location: 100% Remote (U.S.-based)• Up to 10% annual travel for team meetings and limited client onsite engagementsEqual Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.Note:RemoteHunter is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS.