Payment Integrity Analyst II
$66,941–$101,258 year
Remote · Fort Worth, Texas, United States
Job Summary
Payment Integrity Analyst II responsible for reviewing and completing pre- and post-pay claim audits in line with client policies, CMS guidelines, and industry standards. Applies clinical judgment to interpret policies for CERIS reviews (itemized bills, DRG, specialty audits); uses tools to perform audits/appeals; ensures timely completion; participates in clinical and organizational meetings; maintains clear, professional written communication and collaborates with clients and leadership to deliver actionable results. Requires RN/LPN/LVN licensure and healthcare-revenue-cycle experience; preferred Bachelor's degree in healthcare; strong Excel/pivot-table proficiency and attention to detail.
Required Qualifications
- Must maintain a current LPN, LVN and/or RN licensure
- Bachelor’s degree in healthcare or related field preferred
- 1+ years healthcare revenue cycle
- 1+ years of relevant experience or equivalent combination of education and work experience
- 1+ years hospital bill audit
- Proven experience in medical bill auditing or related areas
- Experience with CMS and/or payer audits
- Strong analytical and data analysis capabilities
Apply with one swipe on Sorce. We auto-fill applications and apply on your behalf — no cover letters, no 40-minute forms.
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.