Senior Data Mining and Payment Integrity Analyst

Project overview

Senior Data Mining & Payment Integrity Analyst

Remote, USA

This is an opportunity to join a specialist healthcare analytics team focused on improving payment accuracy and reducing improper healthcare spend. You will play a key role in developing data mining and payment integrity solutions that help clients identify overpayments, strengthen claims accuracy, and support better outcomes across healthcare reimbursement programs.

The Company

They are a healthcare-focused organisation that delivers analytics, auditing, and payment integrity solutions to support health plans and other healthcare stakeholders. Their teams combine domain expertise, data analysis, and technology to improve claims accuracy and reimbursement processes. Working cross-functionally, they develop innovative approaches to identifying billing anomalies and payment issues across complex healthcare datasets.

The Role and Deliverables

Your Skills & Experience

How to Apply

If you have a background in healthcare payment integrity and claims analytics and are interested in a remote contract opportunity, please apply with your latest CV for further information.

• Develop and implement data mining concepts that identify provider overpayments across medical, dental, and pharmacy claims.
• Research healthcare regulations, industry guidelines, reimbursement policies, and provider contracts to design and configure payment integrity algorithms.
• Collaborate with operational, clinical, engineering, and client-facing teams to implement and enhance audit solutions.
• Review and validate analytical outputs, supporting quality assurance and proof-of-concept activities.
• Support appeals, validation, and client services teams by resolving issues related to production analytics and audit queries.
• Document findings, create supporting materials, and contribute new ideas that improve audit processes and payment integrity methodologies.
• Strong experience in healthcare payment integrity, healthcare analytics, or data mining.
• Demonstrated expertise analysing medical, dental, or pharmacy claims data.
• Ability to apply healthcare reimbursement policies, CMS regulations, coding guidelines, and industry standards to claims analysis.
• Experience reviewing and validating claims data and payment accuracy within auditing or payment integrity environments.
• Skilled at translating complex regulatory and reimbursement requirements into scalable analytical solutions.
• Comfortable partnering with technical and non-technical stakeholders to deliver high-quality outcomes.

Project details

• Start: flexible
• Remote: remote
• Location: Remote
• Rate: 50-60 EUR/h