Payment Integrity Analyst I
Healthcare Management Administrators • Bellevue, Washington, United States
Posted: July 8, 2026
Job Description
HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service.
We are proud to say that for three years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results.
What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven.
What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/
How YOU will make a Difference:
The Payment Integrity Analyst ensures assigned payment integrity programs are delivered efficiently and with high quality. Using claims expertise, program knowledge, and analytics capability, this person will provide the day-to-day management of assigned programs which may include, but aren’t limited to, our CMS Demand Case program and our Subrogation program. They will research case questions, resolve issues, identify process and program improvements, and ultimately contribute to the delivery of a strong portfolio of payment integrity programs.
What YOU will do:
- Provide strong analytical, problem-solving and quality assurance skills to support efficient, accurate and timely execution of assigned payment integrity programs
- Combine healthcare knowledge and technical skills using programs including QicLink and Excel and reporting from vendor systems to gather, assess, and perform detailed evaluations of data to:
- Identify issues, recommend solutions, and manage situations to resolution.
- Identify, evaluate and deliver new program improvements that increase cost containment results for HMA and its clients.
- Track, manage, and report on daily program inventory for short-term prioritization and long-term strategic planning.
- Evaluate existing business processes and policies and develop sustainable, measurable improvements.
- Produce clear written documentation to ensure consistent and accurate service provision, such as Procedural Work Instructions or Job Aids for core practices and business requirements for program changes.
- Collaborate effectively with internal teams including Appeals, Claims, Client Success, and Stop Loss to deliver an informed, coordinated experience for clients and members.
- Interact and communicate effectively with payment integrity program vendors and government agencies to meet program expectations.
- Maintain current in knowledge of claims processing, job-related systems, and associated government regulations, and pursue education and training relevant to Payment Analyst role.
- High School Diploma required
- ICD-10 & CPT experience required
- 3-5+ year of claims processing experience within the insurance industry
- 2+ year data entry experience
- Intermediate Excel skills with the ability to build effective spreadsheets and manipulate data
- Able to manage a complex daily queue and prioritize workload effectively
- Skilled in identifying root causes of issues through detailed investigation and inquiry
- Able to analyze impacts of potential actions or decisions to determine the optimal choice
Additional Content
HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service.
We are proud to say that for three years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results.
What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven.
What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/
How YOU will make a Difference:
The Payment Integrity Analyst ensures assigned payment integrity programs are delivered efficiently and with high quality. Using claims expertise, program knowledge, and analytics capability, this person will provide the day-to-day management of assigned programs which may include, but aren’t limited to, our CMS Demand Case program and our Subrogation program. They will research case questions, resolve issues, identify process and program improvements, and ultimately contribute to the delivery of a strong portfolio of payment integrity programs.
What YOU will do:
- Provide strong analytical, problem-solving and quality assurance skills to support efficient, accurate and timely execution of assigned payment integrity programs
- Combine healthcare knowledge and technical skills using programs including QicLink and Excel and reporting from vendor systems to gather, assess, and perform detailed evaluations of data to:
- Identify issues, recommend solutions, and manage situations to resolution.
- Identify, evaluate and deliver new program improvements that increase cost containment results for HMA and its clients.
- Track, manage, and report on daily program inventory for short-term prioritization and long-term strategic planning.
- Evaluate existing business processes and policies and develop sustainable, measurable improvements.
- Produce clear written documentation to ensure consistent and accurate service provision, such as Procedural Work Instructions or Job Aids for core practices and business requirements for program changes.
- Collaborate effectively with internal teams including Appeals, Claims, Client Success, and Stop Loss to deliver an informed, coordinated experience for clients and members.
- Interact and communicate effectively with payment integrity program vendors and government agencies to meet program expectations.
- Maintain current in knowledge of claims processing, job-related systems, and associated government regulations, and pursue education and training relevant to Payment Analyst role.
- High School Diploma required
- ICD-10 & CPT experience required
- 3-5+ year of claims processing experience within the insurance industry
- 2+ year data entry experience
- Intermediate Excel skills with the ability to build effective spreadsheets and manipulate data
- Able to manage a complex daily queue and prioritize workload effectively
- Skilled in identifying root causes of issues through detailed investigation and inquiry
- Able to analyze impacts of potential actions or decisions to determine the optimal choice