JOB PURPOSEA 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. QUALIFICATIONSHigh School Diploma or GED required Associates or Bachelor's degree preferredA minimum of three years’ experience in claims processing required, must include Professional and Institutional processing; previous experience in medical billing and coding required if no claims processing experience.